LIBRARY OF CONGRESS. 



fl&t 






?°f2_ 



UNITED STATES OF AMERICA. 



ACCIDENTS 



EMERGENCIES 



DULLES. 




Showing the Course of the Principal Blood Vessels. 



ACCIDENTS 



AND 



EMERGENCIES 



A MANUAL 

OF THE TREATMENT OF SURGICAL AND MEDICAL EMER- 
GENCIES IN THE ABSENCE OF A PHYSICIAN. 



i 



CHARLES W^DULLES, M.D., 

FELLOW OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA AND OF 

THE ACADEMY OF SURGERY; PHYSICIAN TO THE RUSH HOSPITAL; 

FORMERLY SURGEON TO THE OUT-DOOR DEPARTMENT OF THE 

HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA AND OF 

THE PRESBYTERIAN HOSPITAL, IN PHILADELPHIA, AND 

ASS'T SURGEON SECOND REGIMENT, N. G. PA. 



FOURTH EDITION, 

THOROUGHLY REVISED AND ENLARGED. 
Witft Nrfo Illustrations. 



PHILADELPHIA: 
P. BLAKISTON, SON & 



CO. 



No. 1012 Walnut Street. 
1892. 



^S£P 28 1892 

UiFWASHIIt§522> 






Copyright, 1892, 
by P. Blakiston, Son & Co., Philadelphia. 



Press of Wm F. Fell &. Co., 

1220-24 Sansom St., 

philadelphia. 



Preface to First Edition. 



Whoever has seen how invaluable, in the presence 
of an accident, is the man or woman with a cool 
head, a steady hand, and some knowledge of what is 
best to be done, will not fail to appreciate the 
desirability of possessing these qualifications. To 
have them in an emergency, one must acquire them 
before it arises, and it is with the hope of aiding any 
who wish to prepare themselves for such demands 
upon their own resources that the following sugges- 
tions have been put together. They are not meant 
to be elaborate, but simple and practicable. They 
cannot take the place of calling a physician or sur- 
geon, but may fill up with helpful action what might 
otherwise be a period of inaction and despair, before 
skilled assistance arrives. With this view I trust they 
may prove of some value to the public, to whom 
they are offered. 



Extract from Preface to Second Edition. 



If the author may be permitted to suggest the way 
in which the instrument he has constructed ought to 
be used, it is as follows : Let it be read over, at 
least once, as carefully and as studiously as possible, 
so that the reader may make the acquaintance of its 
suggestions ; and then let it be kept in some handy 
place, where it can be referred to immediately when 
an emergency arises. In order to make it available 
for sudden necessity, pains have been taken to make 
the index as complete as possible, and the typography 
has been so arranged as that leading words may 
catch the eye on every page. 



vn 



Preface to Fourth Edition. 



The call for a fourth edition of this little book 
has afforded an opportunity for a very thorough 
revision of it and the addition of much new matter 
and of new illustrations, which, it is hoped, will 
enhance its usefulness. 

In sending it out, the author invites its readers to 
favor him with any suggestions which may be used 
to make the book, in later editions, better fitted for 
the work it is intended to do. 

4101 Walnut Street, Philadelphia, 
August, 1892. 



Vlll 



Table of Contents. 



PAGE 

Preface v 

Preliminary Remarks 9-1 1 

Obstructions to Respiration 12-20 

Drowning 12 

Strangulation 16 

Suffocation with gases 17 

Choking 17 

Foreign Bodies in the Eye, Nose and Ear . . 21-25 

Foreign Bodies in the Eye 21 

Foreign Bodies in the Nose 23 

Foreign Bodies in the Ear 24 

Unconsciousness or Insensibility ....... 26-32 

Disorder of Circulation 27 

Disorder of Brain 27 

Poison . . . . 28 

Intoxication 28 

Fits or Seizures 33~39 

Fainting 33 

Hysterics 34 

Epileptic Fits 35 

Convulsions in Children 36 

Apoplexy 37 

Intoxication ^8 

Catalepsy 38 

Sunstroke, 39 

ix 



X TABLE OF CONTENTS. 

PAGE 

Injuries to the Brain 40 

Concussion of the Brain 40 

Compression of the Brain 40 

Effects of Heat 41-46 

Burns or Scalds 41 

Sunburn 44 

Sunstroke, or Heatstroke 44 

Heat Exhaustion 45 

Lightning Stroke 46 

Effects of Cold 47-48 

Frost-bite 47 

Freezing 47 

Sprains 49-50 

Dislocations 51-53 

Fractures 54-60 

Wounds 61-71 

Contusions 61 

Contused Wounds 62 

Incised Wounds 62 

Lacerated Wounds 64 

Punctured Wounds 65 

Splinters 66 

Poisoned Wounds 68 

Bites of Serpents , 68 

Stings 68 

Bites of Dogs 69 

Gunshot Wounds 71 

Railroad and Machinery Accidents 72—77 

Lacerations . 73 

Crushes 74 

Shock 75 

Hemorrhage — Bleeding 78-90 

Special Hemorrhages 91-92 

Transportation of Injured Persons 93 



TABLE OF CONTENTS. XI 

PAGE 

Poisons 97~ io 9 

Description of Poisonous Plants 110-118 

Domestic Emergencies 1 19-129 

Cholera Morbus • .... 1 19 

Colic 120 

Vomiting, or Nausea . 120 

Diarrhoea 121 

Dysentery 122 

Croup 123 

Whooping Cough 124 

Asthmatic Attacks 125 

Nervous Attacks 125 

Toothache 126 

Earache 126 

Poisoning with Poison Vine 127 

Neuralgia of Face 127 

Convulsions 128 

Fever 128 

Supplies for Emergencies 130 

Emergency Case 130 

Use of Emergency Case • . . . 133 

Bandaging 134 

Doses of Medicines 137-144 

How to Make Poultices . . . 144 

Signs of Death 146-148 



ACCIDENTS 



EMERGENCIES. 



PRELIMINARY REMARKS. 

There is nothing so important in the presence of 
an accident or emergency as that some one with 
coolness and information enough should assume 
command and begin to set things right. Such a 
one will rarely fail to be recognized by those less 
efficient, and will usually find little difficulty in so 
directing them that they shall render some valuable 
assistance, or, at least, do no harm to the sufferer. 
Bystanders should first be urged not to crowd, but to 
leave room for breathing and action. Any scream- 
ing or wailing should be stopped, if possible. Then 
enough persons, and no more than are needed, 
should be called on to assist in removing the one in 
trouble, or if he be crushed, in removing whatever 
presses upon him. Next, his body should be placed 
in a comfortable position, lying down, with the 
head a very little raised ; after which an investiga- 
r 9 



10 ACCIDENTS AND EMERGENCIES. 

tion may be made to find out, as nearly as possible 
what is wrong, so that an intelligent line of subse- 
quent action may be decided upon. 

Some one should now be dispatched for a doctor, 
with a written message, if possible, and certainly 
with one that shall give the doctor a good idea of 
what he may expect to find when he arrives, so that 
he may come provided with necessary instruments or 
remedies. 

While awaiting him, whatever may be advisable is 
to be done by those at hand. Clothing may have 
to be loosened or removed, efforts at resuscitation 
made, a stretcher or other means of transportation 
provided. Hot or cold applications may be needed, 
and should be made ready. Temporary splints, or 
means to control bleeding, may be required. These 
the bystanders ought at once to attend to. One 
thing, however, they ought not to do. That is, to 
give large quantities of whisky or brandy, as is the 
almost invariable custom with people who know 
nothing, but want to do something. ' If stimulants 
seem to be called for, the non-medical had better 
stick to hot water, or tea, or coffee, or milk ; for 
alcoholic stimulants, except in small quantities, are, 
as a rule, not only unnecessary, but actually harmful. 
They often injure the patient, mislead the doctor, 
and interfere with the proper treatment of the case. 

Exceptions to this general statement may be dis- 
covered ; but they are exceptions — this is the rule. 



PRELIMINARY REMARKS. 11 

Another important point to be observed is, not to 
do too much. It will be making a bad use of 
instructions designed to bridge over the interval be- 
tween the occurrence of an accident and the coming 
of one whose whole time is given to the work of 
healing, if one who knows no more than can be 
gleaned from a little manual should act as if it had 
made a veritable doctor of him. Such presumption 
might lead to great mortification of the amateur 
physician and to the great injury of the sufferer. 
The true principle is, when the urgency is pressing, 
to do what is known to be helpful ; and when one is 
not sure, to do nothing. 



12 ACCIDENTS AND EMERGENCIES. 



Obstructions to Respiration. 



Drowning. It may seem almost absurd to say 
that the first thing to be done when one has been 
exposed to drowning is to remove the person from 
the water. Yet I well remember to have seen, some 
years ago, the revolting spectacle of a woman's 
body, fastened with a rope, floating in a river, and 
gazed at by hundreds of curious people. Upon 
inquiry, a policeman gravely informed me that no 

one dared take it out before the arrival of the 

* 

Coroner. This is a mistake ; any one who thinks 
there is a chance of resuscitation should remove 
from the water a person presumed to have been 
drowned, and at once set about the work. 

Treatment. — If natural breathing has ceased, the 
first thing to be done is to free the body from any 
clothing which binds the neck, chest, or waist, and 
to turn it over upon the face for a moment, thrust- 
ing a finger into the mouth and sweeping it round, 
to bring away anything that may have got in or 
accumulated there. Then the body should be laid 
out flat on the back, with something a few inches 
high under the shoulders (anything will do : a folded 
blanket, or a shawl, or coat, or stick of wood), so as 



OBSTRUCTIONS TO RESPIRATION. 



13 



to cause the neck to be stretched out and the chin to 
be carried far from the chest. The tongue should 
now be drawn well forward out of the mouth and 
held by an assistant, if there be one present. A very 
good way to get the base of the tongue clear of the 
windpipe is to press the angles of the jaw forward 
with both thumbs applied to them just in front of 
the lobes of the ears. 

An effort to secure artificial respiration should 
now be made. The simplest way to 
do this is for some one to place him- 
self on his knees behind the head, 
seize both arms near the elbows and 
sweep them round horizon- 
tally, away from the body 




Fig. i. 

and over the head till they meet above it, when a 
good, strong pull must be made upon them and 
kept up for a few seconds. This effects an inspira- 
tion — fills the lungs with air, — by drawing the chest- 
wall up, and so enlarging the cavity of the chest. 

The second manoeuvre consists in returning the 
arms to their former position alongside the chest, 
and making strong pressure against the lower ribs, 



14 



ACCIDENTS AND EMERGENCIES. 



so as to drive the air out of the chest and effect 
an act of expiration. This need occupy but a 
second of time. 

If this plan is regularly 

carried out it will make 

about sixteen complete 

acts of respiration in a 

minute. It should 





Fig. 2. 



be kept up for a long time, and not abandoned until 
a competent person has ascertained that the heart has 
ceased to beat. The cessation of the pulse at the 
wrists amounts to nothing as a sign of death; and 
often life is present when only a most acute and 
practised ear can detect the sound of the heart. In 
a moderately thin person, deep pressure with the 
finger ends just below the lower end of the breast 
bone may sometimes reveal pulsation in the aorta, 
the main artery of the body, when it cannot be 
found anywhere else. 

It is important that wet clothing shall be removed 
as soon as possible from a drowned person. This 
can always be done without interrupting the artificial 
respiration. If exposure of the person must be 
avoided, something may be laid over the body (a 
coat, a shawl, a blanket, a sail), and the wet clothes 



OBSTRUCTIONS TO RESPIRATION. 15 

may be loosened under it and drawn down over the 
feet. Then the body may be quickly slipped on to 
something dry, and covered with some other fabric, 
if the first has become wet, while this in its turn 
is pulled away from underneath. 

Warmth is to be secured by any means which in- 
genuity may suggest — hot bottles, or plates, or bricks, 
or stones, or even boards that have lain in the sum- 
mer sun. At the seashore there is plenty of hot 
sand, and often plenty of baking bathing costumes. 
The body and limbs may be gently, but constantly, 
rubbed toward the heart, to help the blood in its 
labored circulation. None of these things need in- 
terfere with the efforts to secure respiration, which 
must be uninterrupted. 

Some stimulant is to be given as soon as it can be 
swallowed. Teaspoonful doses of whisky or brandy, 
in a tablespoon ful of hot water, may be given every 
few minutes till the danger point is passed. 

As natural respiration begins to be attempted, it 
should be aided as much as possible by timing the 
artificial to it. It may be stimulated by applying 
smelling salts, or hartshorn, to the nose, by slap- 
ping the skin, or by dashing hot water upon the 
chest. Where it is available, there is no stimulus 
to respiration better than that of a good Faradic 
battery, used so as to bring about reflex sobbing, 
or deep breathing, by the pain it causes. Little by 
little natural breathing will take the place of the 



16 ACCIDENTS AND EMERGENCIES. 

artificial, but it must not be left unwatched for some 
time. 

Nothing but danger from cold, or pressing neces- 
sity, should prompt the removal from one place to 
another of a person who is being resuscitated, before 
this has been thoroughly accomplished. If removal 
cannot be avoided, it must be effected with great 
care. After resuscitation the person should be put 
in a warm bed, being carried carefully, with the head 
low, and a watch should be kept to see that the 
breathing does not suddenly stop. 

Where natural breathing has not ceased, all the 
steps just described should be carried out, with the 
exception of artificial respiration. But this should 
be had recourse to upon the first evidence that nat- 
ural respiration is failing. 

Strangulation, by hanging, or by any con- 
striction of the windpipe from the outside, is to 
be treated by re-establishing the respiration in the 
same way as for drowning. The obstruction is, 
of course, to be removed and natural respiration 
stimulated or artificial respiration employed.* 



*The Philadelphia Press, Sept. 19, 1884, published a report from Pittsburgh 
that a man had been found hanging by a clothesline in an outhouse of the 
Crescent Steel Works the day before. He was discovered by the watchman, 
who ran and called a helper; but neither. would cut the man down until a 
physician had pronounced him dead, seeming to have a confused idea that 
as this is the custom at a public hanging, it ought to be observed at a pri- 
vate one also. 



OBSTRUCTIONS TO RESPIRATION. 17 

Suffocation with Noxious Gases or Vapors 

calls for instant removal to the fresh air and the 
establishment of natural respiration, or of artificial 
until the natural is re-established, as described in 
speaking of Drowning (page 13). Gases like car- 
bonic acid, illuminating gas, the fumes of charcoal, 
and the collections in mines, wells, or privies, are 
very dangerous to life. The removal of a person 
from a well full of a poisonous gas is a very difficult 
and delicate matter. Some attempt may be made to 
dislodge or dissipate the gas. Buckets of water may 
be dashed down, or an open umbrella lowered by 
the handle and rapidly drawn up a number of times. 
But these efforts must not consume any more time 
than is required to prepare a man who can be low- 
ered, securely fastened to the rope, so that he can 
attach another rope to the person overcome in the 
well. The rescuer must be brave, cool, and strong, 
and those who lower him no less so. He may be 
somewhat protected by wearing a sack over his head, 
or having a thick vail or a few folds of a handker- 
chief over his mouth and nose. But everything will 
depend upon the rapidity with which he and his 
comrades can do their work. 

Choking is caused by something sticking in the 
throat, gullet, or windpipe. It is not always easy to 
tell which of these latter passages is clogged, but 
usually there is active irritation, with coughing, when 
a foreign body lodges in the windpipe, while swallow- 



18 ACCIDENTS AND EMERGENCIES. 

ing can be done quite readily. On the other hand, 
when the gullet is stopped it is usually impossible to 
swallow, and there is little or no tendency to cough, 
no matter how much the breathing may be interfered 
with. About the throat, it is not so hard to tell, for 
one can usually see or feel with the finger the offend- 
ing body. 

Treatment. — If a foreign body be within reach of 
two fingers, it may be pretty easily removed. If not, 
a pair of blunt-pointed scissors may be used like 
forceps. Or a hair-pin may be straightened out and 
one end bent round so as to make a loop, and this 
used in trying to dislodge the foreign body ; or the 
handle of one blade of a pair of scissors may be used 
in the same way ; or two small spoon handles may be 
used like tongs to draw it out. It has been stated 
that for foreign bodies in the throat, such as pieces of 
meat, etc., a simple mode of relief is to blow forci- 
bly into the ear. This sometimes excites power- 
ful reflex action, during which the foreign body is 
expelled. Such a plan is so easy of execution that it 
is certainly worth trying. 

Children not infrequently get buttons, or coins, or 
. marbles in their throats, and come near choking to 
death. These may often be pulled out, or expelled 
by vomiting, if this can be provoked. Holding the 
body up by the legs, with the head hanging down, 
has sometimes aided other efforts to get rid of such 



OBSTRUCTIONS TO RESPIRATION. 19 

things. The responsibility of attempts to poke them 
down may well be left to a surgeon. 

If pins, or needles, or fish bones get stuck in the 
mouth or throat, it is sometimes an extremely delicate 
matter to remove them. Sometimes, on the other 
hand, they may be grasped with the fingers or a pair 
of blunt-pointed-scissors — used like forceps — and 
pulled out. If this cannot be done, the patient 
should be made to lie down, and kept as quiet as 
possible in body and mind, until some one comes 
who can give relief. 

If foreign bodies get into the windpipe they will 
soon be coughed out, or require surgical % skill for 
their removal. A moderate blow on the back with 
the open hand, or a quick, strong squeeze of the 
chest, sometimes aids the coughing act ; and invert- 
ing the body may assist in dislodging the foreign 
body if it be not too tightly wedged in. 

In any case in which the breathing is not seriously 
interfered with it will be most prudent for non- 
medical persons to keep " hands off." For there 
may no longer be anything in the throat, though it 
appears there is ; and it can do no good to make 
groping efforts to bring away foreign substances 
that have already gone down into the stomach, only 
leaving behind an irritation which deceives the 
patient and his friends. 

When strange things, like coins, or marbles, or 
slate pencils, or nails, are swallowed by children (or 



20 ACCIDENTS AND EMERGENCIES. 

adults), it is a mistake to give a purgative. The 
proper plan is to let the bowels alone and to give 
for a day or two plenty of good, solid food, espec- 
ially vegetables, like potatoes or corn-meal mush, so 
that the foreign body may be surrounded with the 
waste and carried out of the body without injuring 
the walls of the intestines. 



FOREIGN BODIES IN EYE, NOSE, AND EAR. 21 



Foreign Bodies in the Eye, Nose, 
and Ear. 



Foreign Bodies in the Eye. Small substances, 
like cinders, dust, or small chips of stone or metal, 
can usually be removed from the eye by very simple 
means. Sometimes there is at once a free flow of 
tears, which washes them out. At others, the com- 
mon way of catching the upper lid by the lashes and 
pulling it away from the eyeball and down over the 
lower lid, then letting it go, so that as it recedes its 
under surface is swept by the lashes of the lower lid, 
will clear it out. 

If this does not prove successful, a loop made of a 
horse hair, or a long human hair, can be passed 
under the lid and swept, from the outer side, toward 
the nose and drawn down. This may serve the 
purpose. If it does not, the upper lid must be 
everted, or turned inside out. This is easy to do. 
One way is to seize the lashes between the thumb 
and first finger, and to draw the edge of the lid 
away from the eyeball. At the same moment the 
end of the second finger is pressed against the skin 
of the lid above its edge. The patient is now told 




22 ACCIDENTS AND EMERGENCIES. 

to look down, and as he does so the lashes and edge 
of the lid are pulled upward toward the eyebrow, 
while the upper part is tucked 
under it with the end of the 
second finger. ■ Another plan 
is to draw the lid down, to take 
a slender pencil, or a knitting 
or crochet needle, and place it 
against the eyelid, parallel to 
FlG - 3 - and one-third of an inch above 

the edge, and then to pull the edge up and turn it 
back over this by means of the lashes. 

The lower part of the eye is easy to examine, be- 
cause the lower lid is so easy to turn down. 

In this way a large part of the eyeball and eyelid 
can be examined and any foreign substance removed. 
A magnifying glass is sometimes needed to see frag- 
ments that have given a great deal of trouble. 

One must be on his guard against the sensation 
which is sometimes left after a foreign body has been 
removed from the eye. It often feels to the sufferer 
as though this were still in his eye when it is not. 
But a most careful search should be made before 
this is taken to be a self-deception ; and even then 
it would be better to consult a more skilled person. 

After removing a foreign body from the eye, the 
irritation may be sufficient to demand cool, wet ap- 
plications, or even anodynes. Nothing is better 
than a thin mucilage of pure, clean gum-arabic, 



FOREIGN BODIES IN EYE, NOSE, AND EAR. 23 

poured freely in the eye. Or, a little laudanum may 
be poured into a heated cup, and when evaporated 
to a kind of jelly it can be thinned out with clear 
water and then poured into the eye. A bandage, 
loosely applied, so as to shut out light and keep the 
eyeball rather quiet, often does much good. 

If removal of a foreign body proves difficult or 
impossible, it is usually very soothing to put a drop 
or two of olive oil or castor oil into the eye. 

When lime gets in the eye it burns very severely. 
At once the eye should be deluged with water, and 
a little vinegar or lemon juice and water (a teaspoon- 
ful of vinegar or lemon juice to a teacupful of water) 
poured over the eyeball. 

Foreign Bodies in the Nose. Children some- 
times place, or have placed, in their noses small 
bodies, such as marbles, buttons, peas, beans, or small 
grains. To get rid of them, the nose should be 
blown hard ; or, sneezing may be excited by tickling 
the nose or giving snuff; or, the child may be told 
to take a full breath and then be given a smart blow 
on the back. Some one of these plans may dislodge 
the foreign body. If it does not, it is best to abstain 
from efforts to fish it out, for such efforts may do 
much damage, while the presence of a foreign body 
in the nose is ordinarily neither dangerous nor very 
annoying. When simple efforts to remove a foreign 
body from the nose are unsuccessful a surgeon must 
be called, and the sooner it is done the better. The 



24 ACCIDENTS AND EMERGENCIES. 

longer it is delayed, the harder will be his work and 
the worse for the child. In case peas or beans are 
lodged in the nose, the danger is increased by the 
fact that if they absorb any moisture they swell up, 
and may be very difficult to get away. 

Foreign Bodies in the Ear. The removal of 
foreign bodies from the ear is sometimes very diffi- 
cult, because there is no way of getting at them from 
behind, and there is no natural force to be called to 
one's assistance. Consequently it usually requires 
special instruments and unusual skill. Yet, if no 
medical man be attainable at all, and if it be remem- 
bered that the outer passage of the ear is only about 
an inch deep and very delicate, something may be 
done. 

If the body be a metal or mineral one, the ear 
may be syringed out thoroughly with warm water. In 
doing this, the ear should be gently pulled upward 
and backward, the point of the syringe being placed 
in the upper part of the external canal, so that the 
stream of water can get behind the object and sweep 
it out. The person's head must be held with the 
face down, as in this position gravity lends some 
assistance. Exceedingly gentle efforts may even be 
made to remove a foreign body with a crochet 
needle, or a hairpin, or an ear spoon, if it can be 
had. But with all these it must be remembered that 
irreparable damage may be done by the least rough- 
ness or the least slip. The syringe should not be 



FOREIGN BODIES IN EYE, NOSE, AND EAR. 25 

used if the foreign body is a pea or bean ; for water 
will make either of these swell up and become much 
harder to remove. It should be remembered, also, 
that there is generally no danger in letting alone a 
foreign body in the ear. Most foreign bodies are 
far less dangerous than the efforts made to remove 
them. 

If live insects get into the ear, oil or glycerine or 
salt and water (a teaspoonful to a half pint) should 
be poured in. After about half an hour the ear may 
be syringed in the manner already described. 

An ingenious method, which has sometimes been 
successful, is to turn the ear at once to a bright light, 
so as to tempt the insect to back out, on account of 
the attraction which light has for all these creatures. 



26 ACCIDENTS AND EMERGENCIES. 



Unconsciousness or Insensibility. 



Unconsciousness, or Insensibility, occurs 
in many different conditions, and it is of great 
importance that something should be known about 
them by railway officials and railway servants, manu- 
facturers, superintendents of mines and public works, 
surveyors, constructors, keepers of hotels, and 
schoolmasters and policemen. The former might 
often do priceless service to those who come under 
their care, and the last might escape much blame 
and avoid some unfortunate mistakes, if they could 
always distinguish disease from disorder and drunk- 
enness. 

This, it must be acknowledged, is often hard to 
do. But so much the more reason is there for 
attempting to learn enough to prevent such shameful 
mistakes as are sometimes made. So, before speaking 
of the treatment of conditions in which uncon- 
sciousness may be present, a little space may be 
devoted to considering, in a general way, how one 
may decide what unconsciousness is due to. 

For our present purpose the cause of unconscious- 
ness may be classified as : disorders of the circula- 



UNCONSCIOUSNESS OR INSENSIBILITY. 27 

tion, disorders of the brain, poisoning, and intoxi- 
cation. 

Unconsciousness due to Disorder of the 
Circulation, or temporary failure of the heart, is 
familiarly illustrated in fainting. This may be 
brought about by a simple nervous influence, or by 
a sudden shock, or by loss of blood. In any case, 
the condition is easily recognized by itself or from 
its cause. The loss of consciousness is accompanied 
by paleness of the lips and face, and usually by cold- 
ness of the extremities, with more or less appearance 
of perspiration. 

Unconsciousness due to Disorder of the 
Brain may depend upon disease or injury. Disease 
of the brain is recognizable by its gradual approach, 
which can be learned from the sufferer's friends, and 
is not likely to prove more perplexing than is faint- 
ing. On the other hand, injuries of the brain are 
usually accompanied by external signs, such as dirt, 
swelling, bruises, or cuts, which show that violence 
has been inflicted; or, they occur under circum- 
stances which make a suspicion of violence reason- 
able. In apoplexies some of the external evidences 
might prove misleading, but besides these there is 
often found an unequal enlargement of the pupils, 
and paralysis on one side of the face and body. In 
the unconsciousness of epileptic convulsions there 
is usually little trouble in deciding what is present, 
from the frothing and biting of the tongue or lips, 



28 ACCIDENTS AND EMERGENCIES. 

and the peculiar cry before unconsciousness sets in, 
with which every one is familiar. 

Unconsciousness due to Poison may be 
caused by a poison generated within the body, an ex- 
ample of which sometimes occurs in serious kidney 
disease. In such cases there are usually convulsions 
or twitching of the muscles, and often a dropsical 
appearance about the eyes and legs, with delirium or 
profound stupor, and a smell like that of stale urine 
about the person affected. 

The cause of poisoning by gases is generally easy 
to detect by the aid of surrounding circumstances. 

The only insensibility due to drugs which is actu- 
ally likely to be confused with intoxication is that 
caused by opium or chloral. But in this the pupils 
are strongly and rigidly contracted — the very oppo- 
site to what is seen in drunkenness. 

Unconsciousness due to Intoxication is 
marked, it is true, by many signs of other insensi- 
bilities ; but it has these peculiarities : usually the 
face is flushed and the body relaxed everywhere ; the 
person may be roused by loud cries ; the pupils are 
dilated evenly, and a distinct odor of liquor may be 
discovered. 

When a doubtful case arises, the first thing to be 
done is to see if the odor of liquor can be detected. 
If not, one may be quite sure he is not dealing with 
a case of intoxication. But if, on the other hand, the 
odor is present, one must not conclude at once that 



UNCONSCIOUSNESS OR INSENSIBILITY. 29 

the case is one of simple drunkenness. For it often 
happens that liquor is given after an accident \ and 
an accident may have happened to a man who had 
been drinking. To avoid mistake : — 

i. The head ?nust be examined. If there is a cut 
or a bruise, it is prudent to assume that there is a 
brain injury, received before or after the liquor was 
taken. 

2. The pupils of the eyes must be examined. If 
they are permanently contracted and do not dilate 
when the eyes are shaded, the case is probably one 
of brain disease or opium poisoning. If one pupil 
is contracted and the other is dilated, it is a case of 
injury or disease of the brain. 

3. The face must be examified. If it is drawn 
and wrinkled on one side, and smooth on the other, 
the case is probably one of apoplexy, or stoppage of 
a blood vessel in the brain, or pressure upon some 
part of the brain. 

4. The mouth must be examined. If it be frothy, 
and if the tongue or the lip be bitten, the patient's 
condition is probably due to epilepsy or some other 
convulsive disorder — not simply to intoxication. Of 
course, it must be borne in mind that the tongue 
may be bitten accidentally by being caught between 
the teeth in a fall. 

5. The arms and legs must be exa7nined. If one 
is stiff and one limber, or if one moves when pinched 
and the other does not, the patient has one-sided 



30 ACCIDENTS AND EMERGENCIES. 

paralysis, or hysterics. If the latter, the person 
affected will usually resist any attempt that may be 
made to open the eyelids ; and when the eyelids are 
forcibly opened the eyeballs will usually be found 
persistently rolled up, which may be regarded as an 
almost infallible evidence of hysterics. At the 
same time close watching will generally lead to the 
discovery of some sign that the affected person is 
listening to what is being said about him or her. 

6. The temperature of the shin must be investi- 
gated. If the skin be burning hot and dry, sunstroke 
or heatstroke may be suspected, if the time of year 
or the occupation of the patient warrant such a con- 
clusion. 

After all these tests have been applied, there will 
still be a few cases in which it will be hard to say — 
in the presence of an odor of alcoholic liquor — 
whether there is, or is not, some more serious trouble 
than mere drunkenness present. In these few cases 
the only safe course is to take it for granted that there 
is some other trouble present — even if there be intoxi- 
cation, too — though it be at the risk of being some- 
times deceived and imposed upon. This is of 
especial importance in the case of persons under 
arrest ; for such persons have lost their lives because 
it was taken for granted that they were only " drunk," 
while in fact they were ill or injured — with or with- 
out being drunk also. When there is any doubt the 



UNCONSCIOUSNESS OR INSENSIBILITY. 31 

person should be transported and treated with great 
care, an attempt being made to discover what disease 
or injury, alone or combined with intoxication, has 
produced the condition in which he has been found. 
Such a person should never be made to walk to a 
station house or be confined alone, or be permitted to 
escape the vigilance of those who take charge of 
him, until they can rest the responsibility of his fate 
on others better instructed or in authority over them. 
Treatment. — The treatment suitable for all cases 
in which there is doubt as to the cause of un- 
consciousness is to secure quiet and rest, the body 
being laid upon the back, with the head a little raised. 
If there be great paleness and a cold surface, with 
slow, sighing breathing — the signs of prostration, — 
smelling salts or hartshorn may be held under the 
nose, and hot tea or coffee may be given, while heat 
is applied to the body. If there be great heat of 
the surface, cold may be applied to the body and 
head, and cold drinks given. One precaution must 
always be taken in giving fluids to more or less un- 
conscious persons, namely, to see that the fluids are 
swallowed and not taken into the lungs. Even in 
general unconsciousness, swallowing is usually ef- 
fected as soon as a fluid reaches the back of the 
tongue ; but fluids have entered the windpipe when 
given by the mouth. If such an accident should 
occur, it would at once produce violent coughing; 



32 ACCIDENTS AND EMERGENCIES. 

and this would give warning to stop the administra- 
tion of the liquid. 

With these general remarks on the way to decide 
between simple intoxication and other causes of loss 
of consciousness, let us now consider separately the 
way in which different cases should be managed. 



FITS OR SEIZURES. 33 



Fits or Seizures. 



Fainting is too familiar to need much detail of 
its symptoms. It is due to a temporary weakening 
or pause in the heart's action, causing a diminution 
or suspension of the circulation of blood in the 
brain, and a consequent loss of consciousness. This 
is accompanied with a loss of muscular power, so 
that the individual, if standing, falls. The pallor of 
the skin in fainting is very well known, and is simply 
a signal of the like bloodlessness which obtains in 
the brain itself. 

Treatment, — Usually no treatment is demanded in 
fainting; for a wise provision of Nature puts the 
person who faints in the best position for recovery, 
that is, lying down. But if in any way this is pre- 
vented from happening of itself, it should be brought 
about by a bystander. A fainting person must be 
laid out flat at once. The head must be put as low 
as, or lower than, the body, so that the heart may 
not have to work against the force of gravitation in 
sending blood to the brain ; and heavy wraps, tight 
collars, corsets, or waist bands should be loosened or 
removed. Sprinkling water upon the face and hold- 
ing smelling salts or spirits of camphor to the nose, 



34 ACCIDENTS AND EMERGENCIES. 

tend to excite the nerves of sensation and rouse the 
brain and heart to renewed activity. In using strong 
salts or hartshorn, care must be taken not to scald 
the nose of the patient by holding either too close or 
using it too long. Simple and gentle stimulation is 
usually sufficient to bring a person out of a faint ; 
and if one should be very slow in coming to, it might 
be well to apply heat to the pit of the stomach. 
But of all, the first, the indispensable thing, is to lay 
the fainting person down flat. Nothing should be 
allowed to interfere with this. After a fainting fit, 
from fifteen drops to half a teaspoon ful of aromatic 
spirits of ammonia, or a small quantity of an alco- 
holic stimulant (wine or whisky) may occasionally — 
though very rarely — be useful. The latter is best 
given with a moderate quantity of hot water. 

Hysterics. — Not hysteria, for that is usually a 
tedious and inscrutable nervous disease — but fits of 
hysterics, marked by prolonged and uncontrollable 
laughing or crying, are best treated by the exercise 
of calmness and patience on the part of the by- 
standers, sometimes by taking no notice of the 
attack, or by leaving the unfortunate sufferer in a 
room by herself or himself — for men are at times 
subject to this curious disorder. Heroic measures, 
like dashing water into the face, are not to be gener- 
ally recommended. Good is sometimes done by 
giving teaspoonful doses of valerian or Hoffman's 
anodyne, if it can be obtained. 



FITS OR SEIZURES. 35 

In Epileptic Fits the sufferer usually has a warn- 
ing sensation, and often starts up to leave the place 
he is in. There is in the attack pallor or lividity 
of the face, a peculiar cry, loss of consciousness, a 
moment of rigidity, and then the face becomes con- 
gested and more or less violent convulsions come on. 
In these there is usually some foaming at the mouth, 
the eyes roll or are turned up, and often the tongue 
or lips are bitten. 

Treatment. — Epileptic fits are to treated very much 
like fainting fits, because in them also the brain is tem- 
porarily bloodless. At the same time any movements 
calculated to injure the person must be controlled. 
There is no use in struggling against such movements 
as will do no injury; they had better be simply 
regulated, and no attempt need be made to entirely 
prevent them ; but a folded towel or a piece of soft 
wood may be — if it can be — thrust between the teeth, 
to prevent the usual biting of the tongue. In doing 
this the helper must look out for his own fingers, 
lest they be bitten. When the height of the con- 
vulsion is passed, rest, quiet, and, perhaps, mod- 
erate stimulation may be secured. Here, again, as 
in fainting, the flat position of the body must be 
obtained, and very moderate stimulation may occa- 
sionally be useful after consciousness is restored. 

I remember, one summer, at the seashore, to have 
seen some ill-advised, though kind-hearted, persons 
walking a boy up and down the beach during an 



36 ACCIDENTS AND EMERGENCIES. 

epileptic attack, because, from his pallid face, they 
thought he was suffering from the cold; and they 
were much astonished at the rapidity with which he 
regained entire consciousness when laid out flat on 
the sand. 

It would be a good plan if every one who is sub- 
ject to epileptic attacks had his, or her, name and 
address sewed just inside the coat, or in some place 
where it could be seen at once when the clothing is 
loosened to give relief, as is almost invariably done 
when such attacks occur. Epileptics should not, 
except when it is absolutely unavoidable, go about 
alone, or go into crowded places. They have no 
right, on their own account and for the sake of 
others, to incur the risks involved in such conduct, 
except under the stress of necessity. 

Convulsions of Children and Infants are 
generally (in the absence of brain or kidney disease) 
due to some irritation of the digestive apparatus or to 
teething. They are usually preceded by some other 
evidence of irritation, such as restlessness and fretful- 
ness. When they come on, there is a loss of con- 
sciousness and spasms. These may affect the whole 
body at once, or only a half, or only one limb at a 
time. The eyeballs sometimes roll about, or they 
squint, or they are turned far up, so that only the 
lower part of them can be seen. 

Treatment. — When convulsions occur, the child 
should have cold applied to the head and heat to the 



FITS OR SEIZURES. 37 

body. It often does good to place it into a tub of 
hot water to which some mustard has been added. 

A large injection of hot soapsuds should also be 
given, to clear the bowels out, and, if possible, an 
emetic, in the hope of removing some cause of 
trouble from the stomach. This should be followed 
by a dose of castor oil. 

Apoplexy consists in the rupture of a blood 
vessel in the brain, and is marked by a slow pulse, 
more or less sudden loss of consciousness, stupor, 
heavy snoring breathing, in which one cheek is some- 
times puffed out with each outgoing breath, and 
usually a deeply flushed face. The pupils are gen- 
erally dilated. Paralysis may be observed at once, 
or it may appear after some time. Usually it is 
limited to one side, and may be detected by observ- 
ing that one side of the face is drawn up, while the 
other looks flabby, and the corner of the mouth on 
that side hangs down a little. The flabby side is para- 
lyzed, not the drawn one, as is sometimes supposed. 

Treatment. — For this condition, rest and cold to 
the head constitute the best treatment until medical 
advice — which is indispensable — can be obtained. 
If this cannot be had for some time, the bowels 
should be emptied, if possible, with an injection of 
hot water and soap, and a purgative, like castor oil or 
Epsom or Rochelle salts, should be given by the 
mouth as soon as it can be swallowed. 



38 ACCIDENTS AND EMERGENCIES. 

Intoxication sometimes closely resembles apo- 
plexy, and should be treated in the same way until 
its identity can be safely established. For this the 
odor of the breath is a useful guide, though it should 
never be forgotten that the odor of liquor may be 
due to a stimulant given by a bystander after an 
accident, or taken just before one. In addition, it 
may be remembered that in a case of deep drunken- 
ness there is no paralysis, though there is helpless- 
ness equally on both sides, that the person can be 
aroused from the stupor, and that generally if the 
eyeball be touched with the finger he will attempt to 
close the eyelids. 

Treatment, — In a case of profound intoxication 
an emetic should be given, and, if any hartshorn or 
aromatic spirits of ammonia is at hand, a teaspoon- 
ful of this in a teacupful of water. A large draught 
of vinegar will often go a great way toward sobering 
an intoxicated person. If there is much evidence 
of prostration, with cold, clammy skin, heat will 
have to be applied to the body to prevent collapse. 

Emetics are sometimes of value in cases of pro- 
found intoxication ; but it must be borne in mind 
that, if a mistake be made — as has been — and the 
trouble be an apoplexy, no more dangerous thing 
could be done than to give an emetic. 

Catalepsy is a very rare state, somewhat resem- 
bling death, marked by more or less pallor of the 



FITS OR SEIZURES. 39 

skin, rigidity of the muscles, and apparent uncon- 
sciousness. In itself it is by no means dangerous, 
and it affords time enough to summon a doctor; 
which is the only sensible thing to do under these 
circumstances. 

Sunstroke produces a form of unconsciousness 
which will be considered under the head of " Effects 
of Heat." 



40 ACCIDENTS AND EMERGENCIES. 



Injuries to the Brain. 

Concussion of the Brain, or stunning, may be 
caused by blows or falls on the head, or even by falls 
upon the feet. In such cases there is sickness, some- 
times fainting, with paleness and depression. There 
is also usually confusion of ideas, and the sufferer 
cannot talk continuously and coherently. There 
may even be unconsciousness. 

Treatment. — The proper treatment for this con- 
dition is to lay the sufferer out flat on the back, to 
loosen any clothing that binds his neck or waist, and 
to secure quiet and plenty of fresh air. If the skin 
becomes cold and clammy, heat should be applied 
to the body and limbs. No whisky or brandy 
should be given, except by a doctor's order. 

Compression of the Brain. This is caused by 
the pressure of broken bone upon the brain after a 
fracture of the skull, or by the pressure of blood 
poured out by a hemorrhage inside of the skull. The 
symptoms are loss of consciousness, sometimes par- 
alysis, sometimes twitching of the muscles, or even 
convulsions, and usually heavy, snoring breathing, 
with wide dilatation of one or both pupils. 

The treatment is the same as that for apoplexy. 
(See p. 37.) 



EFFECTS OF HEAT. 41 



Effects of Heat 



Burns or Scalds are usually dangerous in pro- 
portion to their extent, rather than to their depth. 
Those which involve as much as half the surface of 
the skin are almost necessarily fatal. 

The treatment of burns may be considered under 
two heads. The first is for the moment of the 
accident. When clothes are on fire the wearer must 
not run about, but lie down and be covered with a 
rug, or blanket, or carpet, or shawl, or coat, — any 
woolen thing (not cotton or linen, for these take 
fire too easily), which will exclude the air and 
smother the flame. It is especially important to 
keep flames from the face, if possible. If, in fright, 
the sufferer lose presence of mind, some bystander 
must take the responsibility of throwing her (for 
these accidents usually happen to women, on account 
of the character of their clothing) down and envelop- 
ing her with some thick cover. 

After an extensive Burn or Scald, so much 
of the clothing as has to be removed must be clipped 
away (using sharp scissors,) so as not to burst blisters 
that have formed. These may be punctured at one 
edge and their contents allowed to run out, and the 

D 



42 ACCIDENTS AND EMERGENCIES. 

elevated cuticle, or outer skin, to fall down upon the 
deeper layer. Then a dressing of pure sweet oil, 
or castor oil, or any oily substance free from salt, 
like liquid vaseline or new-washed lard, should be 
applied on strips of soft old linen, and disturbed as 
little as possible afterward. It is customary in hos- 
pitals to clip away the clothing and envelop the 
patient in lint soaked in " Carron oil " (which is a 
mixture of equal parts of linseed oil and lime-water*), 
and to administer stimulants and anodynes. In 
case of a person severely and extensively burned, 
the entire body may be immersed in a bath, kept at 
a temperature of ioo°. When the shock of a burn 
is great, moderate quantities of some stimulant 
should be given, and laudanum, in twenty-drop 
doses to an adult, and half as much to a child, may 
be used to allay suffering. The amount of pain in 
very extensive burns is much less than is generally 
supposed. Those who see many cases of severe 
burns know that there is usually not much pain in 
fatal cases; in fact, the absence of pain sometimes 
leads the friends to indulge in false hopes of the 
patient's recovery. 

Slight Burns or Scalds are best treated by 
applying a cloth soaked in a solution of baking soda 

* To make lime-water, put a piece of unslacked lime the size of a very 
large walnut into a common-sized bottle containing a pint or two of cold 
water, shake it up a few times, then let it settle. One need not fear making 
it too strong; the water will take up only a certain quantity of the lime, 
however much is put into it. 



EFFECTS OF HEAT. 43 

(the bicarbonate) in the proportion of a heaping 
tablespoon ful in a teacupful of water ; or the soda may 
be powdered on without using any water. This 
usually allays the pain more effectually than any- 
thing else that is known. Carron oil is a good 
application for such burns. So is the white of egg ; 
and in an emergency damp earth might be used, or 
soapy water, or white lead paint. A good applica- 
tion for burns may be made of strips of linen or 
muslin soaked in a mixture of a teaspoonful of car- 
bolic acid, two tablespoon fuls of glycerine, and a pint 
of olive-oil, or in carbolized vaseline, obtained at a 
drug store. Anything may be used which will prevent 
friction and exclude the air ; but nothing should be 
used which will stick in cakes and prevent after- 
examination, or make this very painful. For this 
reason flour and cotton-batting, though often recom- 
mended, had better not be used. For small burns, 
simple cool water is better in every way than these. 
Indeed, for any but the most extensive burns it is 
one of the best remedies. An arm or a leg can be 
immersed in it and left there a long while with great 
advantage. 

Burns with Acids must be deluged with water 
and then treated like other burns.* 

Burns with Caustic Alkalies, such as soap- 
lye, should be treated with an application of vinegar, 
followed by applications of oil.* 



*For the treatment of cases in which acids or alkalies are taken into the 
mouth or swallowed, see under " Poisons.'* 



44 ACCIDENTS AND EMERGENCIES. 

Burns with Hot Pitch. After such burns the 
pitch often sticks. In such a case it ought not to 
be removed, but let alone until it is coming off of 
itself. 

Sunburn, and the burns caused by external appli- 
cations, like mustard or Spanish flies, may be treated 
very successfully with baking soda. This may also 
be mixed with vaseline, or cosmoline, or lard from 
which the salt has been boiled out, and the mix- 
ture used as an ointment. 

Sunstroke, or more properly Heatstroke, is not 
even usually due to the direct rays of the sun, but 
rather to a prolonged elevation of the bodily tem- 
perature, oftenest while working, especially in con- 
fined places. When it takes place in the open air it 
is apt to be on oppressive, heavy, or murky days. It 
is generally preceded for some time by pain in the 
head and a sense of oppression. The attack, how- 
ever, culminates in a loss of consciousness, with 
heavy, labored breathing, and an intense, burning, 
dry heat of the skin, while the bladder and bowels 
are often involuntarily evacuated. The absence of 
perspiration in the presence of so great heat is one 
of the most characteristic symptoms of heatstroke. 

Treatment. — The treatment of heatstroke consists 
in lowering the temperature. As much of the cloth- 
ing as possible must be removed, and the patient 
must be transported to a cool and airy place, if pos- 
sible. Cold must then be applied to the head and 



EFFECTS OF HEAT. 45 

body in the form of cold water or ice rubbed over 
the chest and placed in the armpits. 

Pouring, or dashing, cold water over the body is 
not to be advised, as it conveys a needless shock to 
the system; but there is nothing better than to place 
the body in a cold bath, or to wrap it in sheets kept 
wet and cold by renewed applications of cold water 
or ice. After a while consciousness will return. 
Then the cold may be discontinued, to be renewed 
only if the surface becomes again very hot — that is, 
hot in contrast to that of a well person, not in con- 
trast to the ice or water that has been used — or in 
case consciousness should be lost again. 

It must always be remembered that sunstroke, or 
heatstroke, is a very dangerous thing, and may be 
followed by grave and permanent impairment of the 
intellect. 

Heat Exhaustion. This is a condition of great 
depression of the system due to the action of heat, 
and, occurring in hot weather, it might be con- 
founded with sunstroke or heatstroke. But in heat 
exhaustion, instead of a hot, dry skin, there is a cold, 
moist one. 

Treatment. — Heat exhaustion must be treated with 
rest and fresh air, in a cool apartment \ but there 
must be no application of cold to the surface. 
Small doses of brandy, thoroughly diluted, may be 
given, so that the system may be gradually brought 
back from its depression. 



46 ACCIDENTS AND EMERGENCIES. 

Lightning Stroke is marked by evidences of 
shock, with reduction of the force of the circulation, 
weak pulse, and slow, sighing breathing. Its entire 
treatment consists in moderate rest and stimulation, 
with warmth applied to the body. Nothing else can 
be done for the sufferer. 



EFFECTS OF COLD. 47 



Effects of Cold. 



Frost-bite sometimes takes place in so insidious 
a way that the sufferer is not aware of it until great 
damage has been done. Toes are perhaps oftenest 
frozen or frost-bitten in this part of the world, partly 
because of the practice of wearing tight and in- 
sufficient coverings on the feet. Frozen fingers, ears, 
or noses are of less frequent occurrence, but they are 
common enough in colder climates. 

Treatment. — All forms of frost-bite or local freez- 
ing are to be treated in the same way, which consists 
in gradually bringing the temperature up to the 
normal point (about 99 Fahrenheit) and maintain- 
ing it there. For this purpose moderate friction may 
be used, or soaking in moderately hot water or with 
hot, wet cloths. Rubbing with snow is used in cer- 
tain countries where snow is plenty and the custom 
is well established ; but warmth is what is needed, 
and there is no virtue in the cold of the snow — the 
rubbing does the good. The practice of soaking 
frosted feet in ice water will soon be abandoned by 
any one who gives a fair trial to warm water. 

Freezing. If the whole body has been long ex- 
posed to extreme cold, there will follow a depression 



48 ACCIDENTS AND EMERGENCIES. 

of vitality which requires the most cautious treat- 
ment. To restore the sufferer, restoration of his 
bodily warmth is indispensable. This may be 
effected by immersing him in a warm bath, which 
should be made gradually warmer until it is as hot as 
can be well borne. Surrounding the patient with 
heated blankets, or exposure before an open fire may 
be used if the bath is not conveniently obtainable.* 
At the same time stimulants in moderate quantity, 
such as hot tea or coffee, may be given internally 
with the addition of small quantities of spirits. 



* This recommendation is contrary to popular belief and contrary to 
what is taught in most text-books, as well as in books on the treatment of 
emergencies. But it is correct, as has been repeatedly and abundantly 
shown by experiments made in Russia, where it was found that the best 
way to resuscitate dogs which had been frozen was to put them at once into 
a hot bath. In one set of experiments, of twenty animals treated by the 
"gradual " method in a cold room, fourteen died ; of twenty introduced at 
once into a warm room, eight died ; of twenty placed immediately in a hot 
bath, all recovered. 



SPRAINS. 49 



Sprains. 

Sprains are sometimes quite trifling injuries, and 
require no treatment but a little rubbing or a little 
rest. At other times sprains are more serious and 
require as careful treatment as fractures do. In all 
forms of sprain, rest is the most important thing to 
be secured, and after this comes moist heat. 

To secure rest, a bandage will sometimes suffice, 
or a sling, or both. The ankle or foot may be helped 
by having a neatly folded towel (as they come from 
the ironing table) folded again so as to make a sort 
of trough splint and placed round it before the ban- 
dage is put on. For the purpose of applying moist 
heat, such a towel splint may be soaked with hot 
water and partly wrung out before it is applied to the 
sprained part. 

Besides this mode of treating sprains, wooden or 
other splints may be used if necessary and con- 
venient. 

In Sprains of the Wrist the hand and forearm 
may be laid on a straight splint, covered with cotton 
or wool so as to make the surface soft, and be lightly 
secured to it with a soft bandage or broad strips of 
sticking plaster. One of these should go round the 



50 ACCIDENTS AND EMERGENCIES. 

hand and one or two round the forearm above the 
wrist — not over it. The bandage should cover all. 

Sprains of the Ankle should never be treated 
lightly. In them there is not unfrequently a frac- 
ture of the inner surface of one of the leg bones that 
form the ankle joint. This complication gives rise 
to so much trouble, and requires such skillful and 
patient treatment, that it has come to be believed 
that it is better to have a broken leg than a sprained 
ankle. The general principle, however, in the case 
of a sprained ankle is : first to put the joint at com- 
plete rest, then to allay inflammation, if it arises, and 
afterward to promote the absorption of inflammatory 
products. For the first, a splint and bandage usually 
suffice; for the second, applications of hot water; 
for the third, friction and kneading of the joint, 
with careful motion of it, and alternating hot and 
cold douching. But in few cases is it truer that " he 
who doctors himself has a fool for a patient." 



DISLOCATIONS. 51 



Dislocations. 



A dislocation consists in the displacement of the 
articular or joint end of a bone. It cannot occur 
(except when the same joint has been out of place 
before) without the tearing of ligaments whose func- 
tion it is to keep the joint close. A dislocation can 
be detected by the occurrence of pain and compara- 
tive immobility of the joint. There is also deform- 
ity, which can generally be made apparent by com- 
paring the injured joint with the corresponding sound 
one of the other side. 

Dislocation of the Fingers can usually be 
reduced — or put in place — by strong pulling, aided 
by a little pressure upon the parts of the bones 
nearest the joint. These must then be retained in 
place with a splint and bandage, or sticking plaster. 
Dislocations of the thumb are, even for surgeons, 
sometimes almost impossible to put in place. 

Dislocation of the Lower Jaw may be treated 
by almost any one. This is fortunate, since it is 
a very awkward dislocation and very trying to the 
patient. It may occur at any time and under the 
most unexpected circumstances. 

To reduce a dislocation of this sort, the sides of 



52 ACCIDENTS AND EMERGENCIES. 

the jaw must be seized between the thumb and fingers 
of each hand, with the thumbs resting on the teeth 
and the fingers below the jaw, and firm pressure 
must be made, first downward and then backward. 
It is important to cover the thumbs with several 
thicknesses of cloth, and as soon as the jaw 
starts into place to slip them off to the outer side 
of the teeth, inside the cheeks, or the releaser is 
likely to be rewarded by having his thumbs mashed 
between the upper and nether millstones. He must 
be very quick, too, for the muscles do not wait, 
when they have been so unnaturally on the stretch, 
but bring the lower teeth instantly against the upper 
like a hammer. 

There is a form of dislocation of the jaw in which 
this is just a little open and cannot be opened any 
wider or closed. The thing to do in such a case is to 
slip a strong spoon handle or table knife in between 
the teeth and to pry the jaw wider open. This will 
make the bone slip back into its place. 

Dislocations of the Shoulder, that is, of the 
upper arm bone from its socket, may be reduced by 
laying the patient down, sitting alongside of and 
facing him, and placing the nearest heel (with the 
boot or shoe removed) in the armpit of the injured 
side, and then drawing down the dislocated arm and 
dragging it over toward the sound side. This will 
usually pry the head of the bone outward and upward 
into its place. If this does not succeed readily, the 



DISLOCATIONS. 53 

amateur surgeon had better let the dislocation alone. 
If it does succeed, the bone will go in with a snap. 
The arm should then be bound to the side, with the 
forearm carried across the chest and the hand placed 
on the opposite shoulder. 

Dislocation of other Joints ought not to be 
tampered with at all. The best that can be done 
for them is to put the parts in the position easiest 
to the sufferer, to surround the joint with cold, wet 
cloths, to which laudanum has been added, and to 
send for a surgeon. The risk of doing injury by 
injudicious efforts to set a joint is greater than that 
of waiting until a surgeon can be summoned. 



54 ACCIDENTS AND EMERGENCIES. 



Fractures — Broken Bones. 



Broken bones may be recognized by the occurrence 
of pain, of deformity, of bending where they ought 
not to bend, and of a sound and feeling of grating 
at the point of fracture. There are two important 
divisions of fractures. Simple fractures, in which 
the break does not communicate by a wound with 
the air, and compound fractures, in which the bone 
cuts through the skin, or there is an opening from the 
exterior to the seat of fracture. The latter are far 
more serious and dangerous than the former. 

Broken bones require treatment as various as the 
fractures themselves are. Most of them require 
special appliances, known only to surgeons, and no 
attempt should be made by any one who has not 
surgical training to do more than treat a fracture 
temporarily. However, until the presence of a sur- 
geon can be secured, the following suggestions may 
be adopted, as far as the circumstances will permit. 

Fracture of the Upper Arm. In this the elbow 
should be drawn down and placed against the side of 
the chest, with a layer of muslin or linen between to 
keep the two skin surfaces from coming in contact, as 
this (especially in summer, when perspiration is free) 



FRACTURES — BROKEN BONES. 55 

might cause irritation and even an inflammation of 
the skin. Then the whole upper arm should be bound 
securely to the body, and the forearm carried in a 
sling so arranged that the hand shall be raised a little 
higher than the elbow. This last point is very im- 
portant, for if the hand is lower than the elbow it is 
likely to swell and become painful. 

Fracture of the Forearm. In this the arm 
should be bent to a right angle at the elbow, and 
placed in as nearly a natural position as possible, 
with the thumb pointing up. Then a broad, well- 
padded splint should be placed along the back of the 
forearm and hand, going all the way to the tips of 
the fingers, and another along the front, padded so 
as to fit to the proper shape of the parts. The 
splints should be bound on snugly but not too firmly, 
and the hand carried in a sling which will raise it a 
little higher than the elbow. In extemporizing a 
sling for the arm, the sleeve of a coat or shirt may 
often be utilized by pinning it across the chest ; or 
part of the frock of a coat may be turned up and 
pinned to the body of it. In using a handkerchief 
or other cloth, this should be folded into a triangle 
and the long, straight edge placed next to the hand. 
The angle should be carried back toward the elbow 
and may be pinned fast there. This will support the 
whole of the forearm equally. 

Fracture of the Finger. A broken finger 
should be straightened out, and bound to a very 



56 ACCIDENTS AND EMERGENCIES. 

light splint reaching from the wrist to the tip of the 
finger. The splint is more comfortable if applied to 
the back of the hand and finger. It should be, of 
course, padded. 

Fracture of the Thigh Bone. In this fracture 
the thigh must be bent up toward the abdomen and 
the lower leg back toward the thigh, so as to relax 
all the muscles. Then one splint can be applied to 
the outer side of the thigh and one to the inner, 
and bound to it. As a temporary arrangement, the 
sufferer may then have both legs tied together, and 
lie on his side on a firm bed with the broken limb 
uppermost, the heel drawn up near to the buttocks, 
and the knee opposite the other knee. A pad 
must always be placed between the knees, or the 
pressure of one on the other may cause much discom- 
fort. 

Fracture of the Knee-pan. In fracture of 
knee-pan (or knee-cap) the whole leg must be bound 
to a straight splint placed at the back of the limb 
and going from the hip to the heel. A folded towel, 
or other pad about three inches thick, should be 
placed in the hollow at the bend of the knee, so that 
the leg may not be held absolutely straight \ for this 
position soon becomes very painful. The part under 
the heel must also be well padded. Then the whole 
leg should be raised at an angle of about forty- 
five degrees with the body, and supported with 
pillows. 



FRACTURES — BROKEN BONES. 



57 



Fracture of the Leg below the Knee. In this 
fracture the leg should be drawn down and placed in 
a natural position, using the sound leg for compari- 
son. Then a pillow should be placed under it. 
Under this, broad bandages should be passed and 
tied together over the limb, so as to draw the sides 
of the pillow pretty firmly up against it. (See Fig. 4.) 
A light piece of board, or several such pieces, may be 
bound on afterward to secure greater steadiness, or 




Fig. 4. 



the other leg may be used as a splint, by binding the 
injured one to it. 

In Fracture near or at a Joint it is best to 
bend the limb a little and lay it flat on a pillow, 
keeping it cool and moist. Breaks at or near a 
joint are especially serious, and demand the best skill 
that can be obtained. 

Fractures of Bones that lie deep in the 
body, like the hip bone or the shoulder blade, are, 

E 



58 



ACCIDENTS AND EMERGENCIES. 



fortunately, very rare. They are hard to detect, and 
can be treated only by placing the sufferer in a com- 
fortable position and securing rest and coolness until 
a surgeon comes. If there is much pain opium in 
some form should be given — a tablespoonful of pare- 
goric or a half teaspoonful of laudanum, to an adult. 
Fractures of the Ribs must be treated in the 
same way. It is a good plan, however, to put on 
the side of the chest where the break is long strips 
of sticking plaster, about two inches wide, placed 
parallel to the ribs and ap- 
plied very snug, beginning at 
the lowest part of the chest 
and going up, each strip 
being made to overlap the 
one below about half its 
width. The strips should ex- 
tend from the spinal column 
to the middle of the breast 
bone. This makes the chest 
wall more rigid and prevents 
the rubbing together of the 
broken ends of the bone. 
(See Fig. 5.) 

In Fracture of the Collar-bone the patient 
should be laid on his back, on a hard, flat, hair 
mattress, or on a settee, with a folded blanket under 
him (never on feathers), without any pillow, and 
kept so until the surgeon comes. This is one of the 




Fig. 5. 



FRACTURES — BROKEN BONES. 



59 




best ways to treat a broken collar bone until it is 
quite healed. 

In Fracture of the Jaw, the parts of the bone 
should be put in position as 
nearly as possible, using the 
rows of teeth as a guide. 
Then the jaws should be 
closed and a bandage put 
round, so as to keep the two 
rows of teeth against each 
other. (See Fig. 6.) 

In Fracture of the Skull 
there is nothing the non- 
medical can do better than 
to place the patient on his 
back, with the head very 
slightly raised, and to apply cold, wet cloths to the 
head. If much time must elapse before a surgeon 
comes, it is well to give a brisk purge or an injection, 
so as to get the bowels well cleaned out. 

Fractures of the Spinal Column (broken 
back) are very hard to detect, but if one be suspected 
the patient must be moved as little as possible. He 
had best be laid out upon his back, and, if possible, 
he should not be disturbed until the surgeon directs 
it. Turning such a patient over upon his face may 
prove fatal, and must not be permitted. 

Compound Fractures, as has been remarked, 
are those in which there is an open wound commu- 



Fig. 6. 



60 ACCIDENTS AND EMERGENCIES. 

nicating with the broken ends of the bone. They 
are to be treated, in an emergency, like simple frac- 
tures in the same locations, with the additional pre- 
caution that they must be thoroughly cleansed and 
kept clean, and the greatest care exercised to keep the 
sharp edges of the bone from doing any further 
damage. 

In all Fractures, cloths wet with cold water may 
be applied to the surface, so as to prevent, as far as 
possible, the swelling which usually comes on soon 
after a fracture, and which often interferes very much 
with the examination of the surgeon. 

Splints. There is nothing in which there is a 
greater call for ingenuity and fertility of resource 
than in extemporizing splints for broken bones. 
Pasteboard, leather, shingles, pieces of cigar box — 
anything fairly smooth and stiff — may be used. A 
surgeon at the seashore got himself no little credit 
once by setting a broken arm on the beach, folding 
up and using as a splint a large newspaper which he 
had been reading. The chest usually serves as a 
very good splint for the arm ; and when a leg is 
broken, the other one will make a good temporary 
splint, or a coat-sleeve, or leg of a pair of trousers, 
stuffed with grass or hay, may prove serviceable. 



WOUNDS. 61 



Wounds. 



In studying wounds we will adopt the classifica- 
tion customary in works on surgery, viz., contusions, 
contused, lacerated, punctured, poisoned, incised, 
and gunshot wounds. 

Contusions are what are usually known as bruises, 
and almost all wounds of the soft tissues caused by 
blows. They are sometimes very painful, and are 
often followed by discoloration, due to the escape 
of blood under the skin from the small vessels of 
a part. A " black eye " is a familiar example of an 
injury of this sort. 

Contusions are sometimes very simple ; as in the 
illustration just given. Such contusions are best 
treated at first, when painful, by the application of 
cold, wet cloths. Pure laudanum, or laudanum and 
water in equal parts, is often a very acceptable appli- 
cation. Later, when the pain has subsided, hot, 
wet cloths are best, as they favor the carrying off of 
the blood that has escaped. 

Contusions of the Chest or Abdomen may 
be very serious ; for, besides the external bruises, 
important internal organs may be injured. Evi- 
dence of this may be seen in spitting of blood or 



62 



ACCIDENTS AND EMERGENCIES. 



vomiting it, or passing it from the bowels or from 
the bladder; or there may be great depression. In 
such cases little can be done by the non-professional 
person beyond securing complete rest and sustaining 
the strength of the sufferer by means of warmth 
applied externally and careful stimulation internally, 
as described in speaking of Shock — to which refer- 
ence may be made. 




Contused Wounds. These are cuts or tears 
accompanied with bruising of the tissues. They are 
to be treated like lacerated wounds (see page 64). 
Unless they bleed freely, warm applications are 
better suited to such wounds than are cold ones. 

Incised Wounds, or clean cuts, if simple and 
small, call only for a piece of sticking plaster, and 



WOUNDS. 63 

perhaps a bandage. If large, the edges should be 
brought as near together as possible, and supported 
so with strips of sticking plaster (as shown in Fig. 7), 
or bandages, or the hands, until the coming of a 
surgeon. If an entire part be cut off, such as an ear, 
or a nose, or a toe, or a finger, it should be cleaned 
with lukewarm water and put in its place, and kept 
warm, leaving to the surgeon the decision whether 
or not it be worth while to try to save it. Some 
very remarkable cases of reunion of such parts are 
on record, and an attempt to save them is not to be 
lightly rejected. 

Any person with fair skill and some nerve may stitch 
a wound, if it seems necessary, using a clean needle and 
plain black silk, and taking care to pass the stitches 
quite through the skin, and to adjust the edges accu- 
rately. Hairy parts should be shaved before stick- 
ing plaster is applied to them. On the head the 
hair can sometimes be used to tie across the wound, 
so as to bring its edges together. 

Cuts of the Walls of the Abdomen are often 
followed by escape of a portion of the bowels. 
These, if dirty, should be cleansed with warm water 
and a gentle effort made to restore them to their 
place. If this fails they should be covered with a 
clean white cloth soaked in warm water. The cloth 
should be kept warm and wet by means of a gentle 
stream of water or by laying on it a sponge soaked 
in warm water, which should be constantly renewed. 



64 ACCIDENTS AND EMERGENCIES. 

Cuts of the Chest Wall may be followed by 
escape of a portion of lung. This should be treated 
in the way just described for escaped bowel, except 
that no attempt should be made to push it back, for 
this is more likely to do harm than to do good. 

Cut-throat Wounds usually require, in addition 
to the ordinary treatment of the wound, that the head 
shall be bent forward, with the chin close to the breast 
bone, and kept there. 

The way to wash delicate structures, such as 
the intestines, or raw cut or torn surfaces, may 
be described here — and it is a good plan to learn 
to do such things by practicing them before the 
emergency arises. Dip a sponge in water, and hold 
it in the closed hand, with the thumb uppermost, 
and a corner of the sponge hanging below the 
fist. Now, on squeezing it regularly, a single stream 
of water will flow softly and steadily down from it. 
The size of this stream can be regulated by the way 
the sponge is squeezed ; its force, by the height to 
which the sponge is raised. This is the only way 
of cleaning off delicate tissues that is safe in the hands 
of the unexpert. 

Lacerated Wounds are tears with ragged edges, 
such as are often caused by machinery, bricks, clubs, 
timbers, stones, dull tools, glass, hooks, etc. These 
often require surgical skill. Until it can be ob- 
tained, however, the torn parts may be placed as 
nearly as possible in their natural position (after re- 



WOUNDS. 65 

moving, with a stream of lukewarm water, squeezed 
from a sponge, any foreign matters that can be so dis- 
lodged) and covered with a cool, wet cloth, or a 
cloth soaked in laudanum or alcohol. If the tear 
has been very great, and the sufferer is depressed and 
cold, teaspoonful doses of brandy or whisky, in hot 
water, may be administered, and a cloth wrung out 
of hot water may be placed over the injured parts. 

Punctured Wounds are made with sharp- 
pointed objects, like arrows, pins, needles, nails, 
tacks, fish-hooks, glass, thorns, or splinters. 

Pin Wounds rarely do much harm ; but they 
may be well squeezed while held in quite hot water, 
so as to provoke a pretty free flow of blood, which 
will wash out any poisonous matter that may have 
been deposited in the wound. 

If a Needle is run into the flesh and comes out, 
always examine it or its pieces carefully ; and if any 
part, from point to eye, is missing, call a surgeon. 
Meanwhile keep the wounded part perfectly still, 
and make no attempt to remove what remains. 
This would probably be quite in vain, and would 
only increase the difficulty of the surgeon's work 
when he arrives. The broken needle should be 
carefully kept and shown to him, as he will then 
know better what to look for in his examination. 

Wounds with nails or tacks are usually situated in 
the foot. In treating them one must try to make 
sure that no part of the nail or tack remains in the 



66 ACCIDENTS AND EMERGENCIES. 

wound. After this it is often desirable to slightly 
enlarge the opening in the skin, to put the foot in 
hot water and squeeze some blood out. After this 
a dressing of hot water or a clean poultice may be 
used for a while to keep the skin from becoming so 
hard as to keep back any matter which forms. 

A Fish-hook is a disagreeable thing to get in one. 
If this should happen, the best thing to do is to cut 
off the string, push the point of the hook through, 
and draw it out, like a needle in sewing. If it can 
be done, the broad part of the hook may be cut off 
before trying this. This may be done with a strong 
pair of nippers or cutting pliers (such as bell hangers 
use), or by means of a strong knife and a hammer. 
The latter method (of which the author has had per- 
sonal experience) is, however, an exceedingly painful 
one. After removing a fish-hook the wound may be 
treated as advised above for pin-wounds. 

Thorns rarely do much harm unless they are 
poisonous ; and poisoned wounds we shall consider 
later. Simple thorn-wounds may also be- treated as 
advised above for pin-wounds. 

Splinters are dangerous in proportion to their 
size and according to the part they enter. Small 
splinters may be picked out with a needle, or cut out 
with a sharp knife. 

Splinters under the Nails sometimes defy 
attempts at removal by the non-medical. But the 
way to succeed is to scrape the nail as thin as possi- 



WOUNDS. 67 

ble over the splinter, then to split it, or cut a little 
tongue out, and remove the splinter. Often when, 
after this, the splinter cannot be removed, it will yet 
come away of itself when matter forms; and in any 
case the sufferer will be much better off for submit- 
ting to this little operation. 

Splinters of Glass are quite beyond most 
people's skill. If any pieces can be removed, this 
should be done. Afterward they are best treated 
with cold, wet applications, and left otherwise en- 
tirely to the surgeon. 

Splinters in the Eye should be pulled out, if 
possible. If not, a few drops of oil may be put in 
the eye and then the eyelid should be gently closed, 
and both eyes should be covered with a layer of cot- 
ton soaked in cool water, and a bandage placed 
round the head, so as to keep the lids as still as pos- 
sible. This bandage should not be too thick or put 
on too tight, and the application should be kept 
cool, with ice, if need be. 

If a large splinter enters the body, an attempt may 
be made to pull it out; but a surgeon should be called 
without fail, and whatever of the splinter has been 
extracted should be carefully saved and shown to 
him. This will aid him in making up his mind 
whether or not the removal has been complete, and 
perhaps save much pain and danger to the patient. 
Splinter- wounds may often be advantageously treated 
like nail-wounds. 



68 ACCIDENTS AND EMERGENCIES. 

Poisoned Wounds may be considered here, as 
they are usually punctured. 

Bites of Venomous Serpents usually demand 
the prompt removal of the seat of the bite. It 
may be cut out instantly by any one who has the 
nerve to do it. Before this, perhaps, the part should 
be encircled, above the wound, with a tight liga- 
ture, and, if small enough, thrust into the mouth 
and sucked hard, so as to extract the poison, or it 
may be soaked in hot water and squeezed so as to 
get some blood out. The immediate application of 
hartshorn to the wound is of advantage ; and a 
knitting-needle or nail, heated to redness, may be 
thrust into it. At the same time, whisky should be 
given in doses just large enough to cause drunken- 
ness, and the intoxication should be kept up until 
medical aid can be secured.* 

Stings of Tarantulas, Scorpions, Centi- 
pedes, Spiders, etc., are to be treated with cold, 
and hartshorn applied to the point where the sting 
entered. 

The stings of insects are rarely dangerous to life. 
They may be treated with cold, wet applications — 
wet earth is a very good one. The application of a 
drop of hartshorn or some wet salt often gives great 
relief. 



* This recommendation is open to certain objections, which need not be 
stated here. It will pass for a popular method of treating snake-bites. 



WOUNDS. 69 

Bites of Cats and Rats are sometimes fol- 
lowed by severe inflammation, but the first treatment 
should be simply cleansing the bites, sucking them, 
perhaps, or squeezing them under hot water, and 
applying cold to them for a time. 

Bites of Dogs are a terror to many people, 
while others have little fear and are very seldom bit- 
ten. Dogs seem to learn who do not fear them. If 
any one be bitten by a dog in good health, only the 
simplest treatment will be necessary. If the dog be 
sick, local inflammation or severe constitutional dis- 
turbance may follow. In case of reasonable suspi- 
cion, the wound may be thoroughly cleansed and an 
application of hartshorn made to it, in addition to 
energetic sucking or soaking under hot water to ex- 
tract any irritating material which may have entered 
it. Dog bites should never be cauterized with lunar 
caustic (nitrate of silver). This is so generally done 
that the author must state that, after years of ex- 
haustive study of the subject, he is convinced that 
such cauterizations are worse than useless. They 
never do good and often do much harm. 

It is a most foolish thing to kill a dog that has 
bitten anybody soon after this has taken place. Such 
a dog should be caught and kept under the observa- 
tion of a person of carefulness, intelligence, and 
special information. The too speedy slaughter of a 
dog has robbed many a sufferer of the assurance that 
would have been gained by seeing it living and well, 
and sent many a one to the grave, as dying of hydro- 



70 ACCIDENTS AND EMERGENCIES. 

phobia, who never had it, but had been bitten by a 
healthy and harmless animal. 

Again, if one has been bitten, and there be a rea- 
sonable suspicion that the dog was what is called 
"mad," let him not despair. Some of the most 
able and careful (that is the greatest matter) medical 
men are of the opinion that most, if not all, cases of 
so-called hydrophobia are spurious ; that is, they are 
not hydrophobia at all. The author has studied this 
subject with great care for years, and has become sat- 
isfied that the popular theory in regard to hydropho- 
bia is utterly wrong. He also believes it will some 
day disappear, as the belief in witchcraft — which not 
long ago was supported by the most respectable medi- 
cal, clerical, and popular authorities — has disap- 
peared. In most of the reported cases the patients 
have been alarmed by what they thought, or 
frightened by what injudicious friends or timid 
doctors have said and done, until they died of sheer 
terror. So, in case of a bite from a supposed mad 
dog, let the things suggested above be done ; and let 
the bitten person reflect how common are dog bites 
and how very few are the cases of even so-called 
hydrophobia. * 

* The author calls attention to the fact that so-called hydrophobia ex- 
ists exactly in proportion to the common belief in it and the amount of 
public discussion it gets. In Paris more cases occur than in any place of 
its size in the world, because there the medical men are continually keep- 
ing the subject before the people. In this country a few New York papers 
are more or less constantly doing the same thing ; though there has been a 
great improvement of late in the way they treat the subject. 



WOUNDS. 71 

Gunshot "Wounds. This is another class of 
injuries occasionally met in civil life, though not 
common. Ordinarily little can be done for them, 
except by a surgeon ; and perhaps all that is advisa- 
ble before he comes is to note and remember the 
position of the body or the wounded part at the 
moment it was struck, and the direction from which 
the missile came, so that these facts may help the 
surgeon in his search for it.* Then cold, wet cloths, 
upon which laudanum may be poured, should be 
kept upon the wound, to prevent, as far as possible, 
inflammatory swelling ; and if, as is very often the 
case, the patient be in what surgeons call a state of 
shock — that is, cold and depressed — teaspoon ful 
doses of wine, whisky, or brandy should be given, 
and heat applied to the surface of the body. (See 
" Shock".) If a part is badly shattered, the local 
treatment should be the same, except that, if there 
be much depression, cold had better not be used at 
all. There is rarely much bleeding from gunshot 
wounds, except when large vessels are divided. In 
such a case the bleeding may be controlled as 
described under the head of hemorrhage. 



* To show how strange may be the course of a bullet, I will cite a case 
which I treated in 1876. A young man was shot with a pistol. The ball 
passed through his lower lip, struck an upper front tooth, which it broke off, 
then glanced downward and backward, diagonally through the tongue, 
and finally buried itself in the floor of the mouth, on the other side from 
that where it entered the lip. 



72 ACCIDENTS AND EMERGENCIES. 



Railroad and Machinery Accidents. 



Railroad and Machinery Accidents may be 

the occasion of simple incised, contused, or lacerated 
wounds, or, as is very common, of severe tears, 
wrenching off of fingers or toes or limbs, or of 
crushes. Saws, planing-machines, cog-wheels, belts, 
and many other machines or parts of machines, cut 
or tear off many a limb or part of one. Such injuries 
almost always occur when no medical aid can be ob- 
tained for some time, and it would be well if some 
one on every train and in every room or place where 
machinery is in motion could have some idea of what 
can be done, and what cannot, before a doctor can 
be had. 

Trifling Injuries, whether cuts or tears, are to 
be treated on the principles already described in 
speaking of incised or lace*rated wounds; that is, the 
parts are to be cleaned as gently and as well as 
possible, by letting lukewarm water run over them. 
Then, any displaced tissue — skin or flesh — may be 
put in place, and a clean, white cloth, soaked in 
laudanum or alcohol or water, may be laid upon the 
wound and bound on loosely with an extemporized 
bandage. 



RAILROAD AND MACHINERY ACCIDENTS. 73 

Hemorrhage is not usually severe after railroad 
and machinery accidents, because the wounds are 
generally inflicted in a way which closes up the 
blood vessels as they are torn or twisted off. 

Large Tears, or Lacerations, must be treated 
by carefully removing any fragments of clothing, or 
dirt or splinters of any sort, and washing with luke- 
warm water. For removing foreign matters, the 
best forceps are in everybody's possession — that is, a 
finger and thumb ; and no one need be afraid to use 
these with reasonable care. They may be aided 
occasionally by touches with a clean linen or muslin 
cloth, or a clean sponge or small mass of cotton ; 
but these must be undoubtedly clean. 

After cleansing is complete, the torn parts must be 
put in position, and kept so by bandages, sticking- 
plaster, or the hands of another person, as may seem 
best. Sometimes a splint is required. This is usually 
easy to prepare in a mill or on a railroad. It may 
be clumsy — that is not of much consequence — but it 
ought to be sufficiently large to keep not only the 
injured part still, but also, in case of a limb, the 
joint above and the joint below the injury. 

Such injuries are often accompanied with com- 
paratively little pain. If, however, there should be 
severe pain, laudanum may be given — about thirty 
drops to an adult. Cold or hot cloths — whichever 
are most comforting — must be applied to the injury, 

F 



74 ACCIDENTS AND EMERGENCIES. 

and symptoms of depression must be treated as de- 
scribed under the head of " Shock." 

When Fingers or Toes are Crushed they 
ought to be washed, modeled into good shape, 
dressed with a piece of soft white cloth which has 
been wrung out of hot water, and laid upon a warm 
splint. 

If a finger or toe hangs by a mere shred, it may 
be cut off entirely. 

When Fingers or Toes are Torn off the 
stumps almost invariably require a scientific ampu- 
tation. But, until this can be decided upon, they 
must be cleansed, and treated with a cool, wet appli- 
cation of some sort, and then not meddled with. 

Hands or Feet that have been Crushed must 
be treated by being wrapped up in some soft, warm 
dressing, like cloth, or cotton, or wool. Cold is 
only to be used if there be profuse bleeding. The 
injured part must invariably be supported with some 
sort of splint and placed about on a level with the 
body. One who has received such an injury ought 
to be made to lie down, unless some other course is 
absolutely necessary for moving him, or is authorized 
by a surgeon. Such injuries rarely cause much pain, 
but they almost invariably cause great depression. 
This must be met by keeping the sufferer warm with 
wraps and hot cans or bricks or bottles, and giving 
him, every few minutes, a small quantity of whisky 
or brandy (a teaspoonful) in a little hot water. 



RAILROAD AND MACHINERY ACCIDENTS. 75 

Larger doses of spirits are not needed. (See 
" Shock.") 

When Hands or Feet have been Torn off 
or cut off with wheels, the stumps are to be treated 
as described, and the limb placed in such a posi- 
tion that the injured point is higher than any other. 
These injuries are usually accompanied with depres- 
sion also, and this is to be combated in the manner 
described for shock. 

Crush of the Arms or Legs is to be treated like 
crush of the hands or feet. But here the prostration 
is usually much greater, and the need for support, 
with warmth and stimulants, more urgent. The 
clothing should on no account be disturbed, except 
in so far as it can be cut away and replaced with 
warm coverings, or as is necessary to find out the 
nature of the injury or to control bleeding. 

Crushes of the Chest are sometimes instantly 
fatal, and almost always cause death in a short time. 
In such cases, as well as in case of 

Crushes of the Lower Part of the Body, 
there is nothing that can be done besides securing 
rest, warmth, and moderate stimulation. The sufferer 
should be made as comfortable as possible, and 
prepared for the almost inevitable issue. 

Shock is a condition which has been alluded 
to already, in speaking of certain injuries. It may 
also be caused by fright, as, for example, that which 
may accompany a trifling gunshot wound. Or it 



76 ACCIDENTS AND EMERGENCIES. 

may be caused by a blow upon the pit of the stomach, 
or by a sudden and severe pain, or even by drinking 
a large quantity of ice-cold water. It is very com- 
mon after gunshot wounds, and almost invariable 
after serious railroad or machinery or mine acci- 
dents. 

The signs of shock are : great paleness, a cold, 
clammy skin, a very feeble pulse and feeble breath- 
ing, a pinched face, dull eyes, drooping eyelids, 
dilated pupils, bewilderment or dullness of mind, or 
even insensibility. A person in such a state may die 
very soon, and will surely die before long, unless he 
can be brought out of the shock. This requires 
prompt, energetic, and persistent effort on the part of 
those who come to his assistance. Heat must be ap- 
plied, if possible, to the whole body, and especially 
to the region of the heart and pit of the stomach. 
This can be done with a hot bath, a hot fire, hot 
cans, hot bottles, stove-plates, heated blankets — in 
fact, anything hot that can be got hold of. 

In applying heat, care must be taken not to burn 
the patient ; for in a state of shock he may not feel 
pain from an amount of heat which would severely 
burn him. 

At the same time hot drinks, to which brandy or 
whisky has been added, may be given in small and 
frequently repeated quantities. To be more exact — 
a teaspoonful of brandy or whisky in a tablespoonful 



RAILROAD AND MACHINERY ACCIDENTS. 77 

of hot water may be given every ten minutes for sev- 
eral hours. 

Manufactories, mines, and railways ought to be 
furnished with appliances for the treatment of this 
condition and some one who knows how to use them \ 
for shock almost always follows severe railroad or 
machinery accidents, and is the most common cause 
of death after them, as any hospital surgeon could 
testify. 



78 ACCIDENTS AND EMERGENCIES. 



Hemorrhage — Bleeding. 



There is no accident so appalling as hemorrhage, 
whether the bleeding comes from an external wound 
or from the rupture of blood vessels in some internal 
part. There is none which calls for so much nerve 
in combating it, nor any in which a little accurate 
knowledge can be more valuable. 

The subject of the control of hemorrhage will be 
better understood after taking a concise view of the 
anatomy of the organs of circulation. This cannot 
be made absolutely accurate without being too tech- 
nical, but the variations from accuracy will not affect 
its practical utility. (See Frontispiece.) 

The blood starts from the left side of the heart, 
and is driven first into the aorta, which curves over 
above the heart and descends along the left side of 
the spinal column, within the chest and abdomen. 
From what is called the arch, at the beginning, are 
given off the vessels which supply the head and arms. 
The former (the carotid arteries) lie, one on each 
side of the windpipe, and divide and subdivide in all 
directions. The latter curve forward and come out 
from the chest over the first rib, and, passing under 
the collar-bone near the shoulder, pass down through 



HEMORRHAGE — BLEEDING. 79 

the armpit and along the inside of the arm to the 
middle of the front of the elbow, and here divide 
into two branches. These pass along the front of 
the forearm, one on the thumb side, and the other 
on the little finger side. Thus, in the upper arm the 
arteries follow nearly the same line as the seam in 
a coat-sleeve. The two arteries of the forearm, en- 
tering the palm of the hand, join in a loop, from 
which vessels run down, one on each side of each 
finger, and one on the inner face of the thumb. 

The aorta, as it descends through the chest and 
abdomen, gives off vessels to supply the internal or- 
gans, and near the lower end of the backbone divides 
and sends a large vessel out through each groin into 
the thigh. Each of these passes down in almost a 
straight line, between the muscles, to the middle of 
the hollow at the back of the knee. Just below this 
it divides into three branches. The first of these 
passes through to the front, between the two bones of 
the lower leg, and runs down under the muscle, close 
to the outer side of the shin bone, and passes out upon 
the instep at about the middle of the front of the 
ankle joint. Here it breaks up into smaller vessels 
that supply the top of the foot. 

The second and third branches of the main artery 
of the thigh pass down the back of the lower leg, 
one on each side, close to the corresponding bones 
and deep under the muscles. One passes back of the 
inner ankle bone into the inner side and sole of the 



80 ACCIDENTS AND EMERGENCIES. 

foot. The other passes back of the outer ankle bone 
to the outer side and sole of the foot. The arteries 
of the sole of the foot like those of the palm of the 
hand, unite to form a loop, from which a vessel is 
given off for each side of each toe. 

This is a brief outline of the course of the arteries. 
As they divide and subdivide, like the branches of a 
tree, they become correspondingly smaller, and they 
end in an inexpressibly fine network of minute ves- 
sels. These are called capillaries. Then, as the 
capillaries are a sort of splitting up of the smallest 
arteries, so, on the other hand, by the confluence of 
a number of capillaries, larger branches result, 
toward which the current of blood constantly sets, 
and the beginnings of the veins are formed. These 
unite in a manner the very reverse of the branching 
of the arteries, and, growing, like rills and brooks 
and rivers, larger and larger by repeated junctions of 
several into one, travel back to the heart in an 
opposite direction to that of the arteries. Of veins 
there are two sets : the deep, which lie alongside the 
arteries, and the superficial, which lie near the sur- 
face just under the skin. Each principal artery has 
at its side at least one vein of corresponding size. 
Up the legs, up the inside of the abdomen and chest, 
up the arms and down the neck they pass, till they 
unite to form one trunk, which empties into the 
right side of the heart. 

From this point the blood is pumped into the 



HEMORRHAGE — BLEEDING. 81 

lungs to be aerated ; from the lungs it is collected 
and emptied into the left side of the heart ; and 
from the left side, as we have seen, it is pumped out 
to begin the circuit through which we have just 
traced it. 

The frontispiece will give a fair idea of the course 
of the main blood vessels, and may make clearer 
what may not have been understood from the pre- 
ceding description. 

It may be observed that the position of the blood 
vessels is always in the safest part of the body or 
limb. They all lie where they are protected by 
bending a limb or a joint — a natural act when 
attacked. They are on the inner side of the arm 
and forearm, when these are used for attack or 
defense. They are on the inner side of the thigh 
and at the back part of the leg — out of harm's way. 
In endeavoring, as shall hereafter be recommended, 
to check bleeding by pressing upon a main blood 
vessel, this fact may serve as a reminder of the 
course it might be expected to run. To which this 
suggestion may be added, namely : When you are 
in doubt, feel for the pulsation of the artery and 
make pressure where you feel it beating. Another 
point, preliminary to considering the methods of 
arresting hemorrhage, is that blood from arteries is 
usually bright red and escapes in jets, while blood 
from veins is dark red or purple, and flows in a steady 



82 ACCIDENTS AND EMERGENCIES. 

stream. Blood from capillaries is of a color be- 
tween these two, and it oozes out. 

Capillary Hemorrhage follows every cut. The 
color of the blood is red \ the flow is generally slow 
and not very considerable. It usually stops of itself. 
If it does not, the part may be elevated and cold 
water or ice or snow, or even vinegar, applied. If 
there is oozing from a large raw surface, a towel may 
be folded, dipped in water as hot as the hand can 
possibly bear, lightly squeezed, so as not to drip, 
and firmly pressed upon the bleeding surface. This 
may have to be renewed once or twice, at intervals 
of a few minutes, but it usually acts like magic in 
this form of hemorrhage. 

Hemorrhage from the Veins is generally slow 
and steady, and the blood is darker than in other 
forms. It rarely demands special effort to control 
it. When severe, the application of cold and firm, 
continuous pressure upon and below the wound 
generally suffice to stop it. A folded linen or mus- 
lin cloth, bound on dry, with moderate firmness, or 
direct pressure with a finger, will usually stop any 
bleeding from a vein. Rupture of varicose veins in 
the leg may lead to dangerous hemorrhage, but this 
can usually be checked by applying a dry pad of 
cloth and binding it firmly down upon the bleeding 
spot. In this case a ligature applied above the wound 
would only make the matter worse, for the blood 
passes up in the veins and not down. 



HEMORRHAGE — BLEEDING. 



83 



A wound of the jugular vein, on the side of the 
neck, is usually followed by dangerous hemorrhage. 
This is to be treated with a pad and press-ure, which 
can be best made with one finger laid above and 
one below the wound. 

Hemorrhage from the Arteries may be very 
dangerous. Here the blood is bright red, and spurts 




in a stream or leaps in jets from the divided vessel. 
If it be from a large artery, like those in the root 
of the neck, or the armpit, or the inside of the thigh 
near the groin, life will usually be quickly lost. In- 
deed, without a thorough acquaintance with anatomy, 
it is hardly likely that any advice that could be given 
here would be available in such cases. The only 



84 ACCIDENTS AND EMERGENCIES. 

thing to suggest is to thrust a finger deep into the 
wound and see if firm pressure there will stop the 
bleeding. * Or some other form of plug may be 
tried. For wounds high up in the neck or about the 
jaw, pressure may be made with the thumb at the root of 
the neck, just outside the windpipe and near the col- 
lar bone, as shown in Fig. 8. One thing must be 
remembered in all cases of hemorrhage, that is, never 
to disturb any clots that have formed ; for they are 
Nature's means of stopping hemorrhage. Another is 
that fainting sometimes puts a stop to bleeding, and 
so far is an aid to the professional or amateur surgeon. 

Every one may, while awaiting skilled aid, do 
something when the arteries of the limb are cut. 
The first duty in all such cases is to be cool as possi- 
ble, then, as quick as is consistent with coolness. 
The principle that must guide every attempt to stop 
the bleeding is to obstruct the artery at the spot, or 
between the centre of the body and where it is cut; 
for this is the direction in which the blood flows. 

For Wounds high up in the Arm, strong pres- 
sure may be made downward, behind the collar 
bone, about at its middle (see Fig. 10). The thumb, 
or the handle of a large door key, well wrapped, so 
as to make a tolerably thick mass, can be thrust 
down, and if it does not seem to strike the artery the 
first time, it can be moved along, toward the breast 
bone and toward the shoulder, to see if it will hit 
the right place. 



HEMORRHAGE — BLEEDING. 



85 



For Wounds of Arteries of the Finger, pres- 
sure may be made on the side that is cut by seizing 
the finger between a thumb and finger and pinching 
it, or by wrapping a cord round, or slipping on a 
rubber band. In wounds of the thumb, pressure 
must be made on the front of the thumb. 

For Wounds of Arteries of the Hand, raising 
this above the head and making firm pressure on the 
bleeding spot, or with both thumbs just above and in 
front of the wrist, will usually stop the bleeding. Or 
the wound may be packed with lint, or cotton, or 
old muslin, or linen, and bound firmly with a band- 
age. If this fail, resort must be had to the measures 
recommended for the next form of hemorrhage. 

For Wounds below the Elbow, first grasp the 
upper part of the arm with the fingers and thumb, as 
shown in Fig. 10, and 
squeeze as hard as possible ; 
then let some one make a 
thick, hard knot, as big as 
an egg 9 in the middle of a 
handkerchief, place it over 
the middle of the front of 
the arm, immediately above 
the elbow, tie the ends tight 
at the back, and bend the 
forearm up, so as to press 
hard against the knot (Fig. 
9). This, if successfully done, will obstruct the 




Fig. 9. 



86 



ACCIDENTS AND EMERGENCIES. 



main blood vessel (the brachial artery), which in 
this place lies in the middle line of the bend of the 
elbow. 

For Wounds in the Upper Arm, pressure may 
be made against the bone on the inner side and just 





Fig. io. 



Fig. ii. 



below the swelling muscle, which most people are 
aware is called the biceps, as shown in Fig. io. A 
knot as big as a fist may then be made in any piece of 



HEMORRHAGE— BLEEDING. 87 

cloth and shoved hard up into the armpit, and the 
elbow brought straight down and held or bound 
firmly against the side of the chest. 

If either of these methods fail, or cannot be car- 
ried out, the " Spanish-windlass " may be used. To 
do this, place some hard, round body, like a stone, 
in a large part of a handkerchief folded diagonally, 
or knot the middle and carry the ends round the 
limb, so as to leave the lump over the position of the 
artery — that is, over the bend of the elbow, or a 
little in front of the middle of the inside of the 
upper arm, near the shoulder. Then tie the ends of 
the handkerchief so as to make a loose loop, slip a 
stick through this, and twist it round and round, so 
as to tighten the handkerchief, till the blood stops 
flowing, but no more! (See Fig. n.) This is a 
much rougher procedure than the method described 
before ; but one cannot be over-particular in such 
cases. So if the former fails, or no bystander is cool 
enough to carry it out, no time must be lost before 
the "Spanish-windlass" is used. 

Wounds of Arteries of the Foot or Leg may 
be treated by firm pressure in the hollow just behind 
the knee (above the calf of the leg). This can be 
effected by placing there a knotted cloth, like that 
suggested for the armpit, and doubling the leg back 
until it presses hard against it. In doing this, the 
thigh must be doubled up toward the abdomen, or 



88 



ACCIDENTS AND EMERGENCIES. 



the bending of the knee will soon become intolerably 

painful. 

For Wounds in the Thigh, pressure must be 

made in the hollow immediately below the groin, 

about two-thirds of the way 
from the hip bone to the 
middle line of the body, 
where the artery of the thigh 
(femoral artery) comes out 
of the body, as shown in 
Fig. 12. This can be effected 
with the thumbs or with a 
rounded stick, or a key 
handle, or with a " Spanish- 
windlass. ' ' The artery may 
also be closed by placing in 
the groin a knotted cloth, or 
a large round stone, and 
doubling the leg back on the 
thigh (this is important), 
and the thigh forward, hard 
against the abdomen. If 
this latter plan does not suc- 
ceed promptly some other 
one of those mentioned 

should be tried, and no time be lost in doing it. 
Bleeding from Arteries of the Scalp can 

be controlled by firm pressure upon and around the 

bleeding point. This can be made with a dry pad 




Fig. 



HEMORRHAGE BLEEDING. 89 

bound on with a bandage, or held on with a finger 
or two. 

Recapitulation. — To go over this briefly again : Re- 
member, first, to keep cool ; second, that the prin- 
cipal object is to obstruct the artery above the cut ; 
and that this can be effected by pressure, in the 
several cases, in front of the bend of the elbow, in 
the armpit, behind the bend of the knee, or just 
below the groin. This can be made with the fingers, 
or with a knot held hard against the artery with a 
tight bandage, or by bending the limb up against it 
— or, in case of the arm, by pressing it hard against 
the chest. In case of failure, the "Spanish-wind- 
lass ' ' is to be applied at the same points. 

In case none of the plans proposed can be carried 
out, a cut that bleeds profusely may be stuffed with a 
rag or dry earth, this being kept in place by pressure 
with a bandage or handkerchief, or the cut part may 
be forcibly compressed in any way, or a finger may 
be thrust into the wound and held wherever it seems 
to do the most good. 

Finally, let it be remembered that clots are not to be 
disturbed, that raising a limb will often put a stop to 
even severe bleeding, and that fainting may put an 
end to hemorrhage, as well as that when conscious- 
ness is restored the bleeding may recur. So this 
possibility should not be overlooked. The treatment 
of a faint under these circumstances — if it is so 
grave or so prolonged that it must be treated — is the 

G 



90 ACCIDENTS AND EMERGENCIES. 

same as that of any faint: in addition to the measures 
demanded to check the bleeding, the head must be 
lowered, the legs and arms may be elevated, and 
warmth applied to the body, while stimulants are 
carefully administered by the mouth. 



SPECIAL HEMORRHAGES. 91 



Special Hemorrhages. 



Bleeding from the Nose is often only Nature's 
way of getting rid of an excess of blood ; but it 
may be so profuse as to threaten life. If this be the 
case, of course medical aid will be summoned. 
Until it arrives the best thing that can be done is to 
put a cold key or a cloth dipped in cold water to the 
nape of the neck. If this does not soon stop the 
bleeding, salt and water (a teaspoonful to a cupful) 
or vinegar may be snuffed up the nose. A dessert- 
spoonful of alum in a cupful of very warm water is 
also useful ; but vinegar is less disagreeable, and will 
rarely fail to check the bleeding, unless the case is 
beyond any except skilled help. 

Bleeding after Extraction of a Tooth is best 
treated by pressing a plug of cotton firmly over the 
bleeding point, and holding it there with the finger 
until a surgeon can be had. 

In Hemorrhage from the Lungs the blood is 
bright red and generally frothy. It is rarely pro- 
fuse, and yet, as it is usually coughed up and caught 
in a handkerchief, it seems to be so. The amount 
can never be safely estimated in this way. The best 
treatment is rest in bed, with the body raised in the 



92 ACCIDENTS AND EMERGENCIES. 

sitting posture, and the swallowing of lumps of ice. 
The application of cold to the chest, although often 
recommended, is rarely advisable. Asaltspoonful of 
salt and a teaspoonful of vinegar may be given every 
fifteen minutes ; but most hemorrhages from the 
lungs stop in a little while without any treatment. 

In Hemorrhage from the Stomach the blood 
is usually very dark, looking like coffee grounds. 
If it is mixed with any other contents of the stomach 
its appearance may be masked. In such cases ice 
water or broken ice may be swallowed, and teaspoon- 
ful doses of vinegar. Rest in bed must, and the 
application of cold to the stomach may, be em- 
ployed. 

Hemorrhage from the Bowels may be treated 
with injections of a teacupful of ice water and the 
application of ice to the abdomen. Fortunately, 
these hemorrhages are rarely dangerous, and the 
tendency to them can often be corrected by the use of 
simple laxatives and regular attention to the move- 
ments of the bowels. 

In Internal Hemorrhage of women ice-cold 
cloths may be placed upon the abdomen. One of the 
most efficient modes of checking such hemorrhages 
is to use large injections of water as hot as can be 
borne, directed to the source of the bleeding. Rest 
in bed, without a pillow, and with the head lower 
than the body, must also be secured. 



TRANSPORTATION OF INJURED PERSONS. 93 



Transportation of Injured Persons. 



If injured persons have to be removed from one 
place to another, it is worth while to know how to 
do it with the greatest ease and safety to them. If 
a door, or shutter, or settee is at hand, any of these 
will make a good litter, with a blanket, or shawls, 
or coats for pillows. In placing a person upon a 
stretcher, it should be laid, not alongside of him, 
but with its foot at his head, so that both are in the 
same straight line. Then one or two persons should 
stand on each side of him, and, raising him from the 
ground, slip him up on the stretcher. This can be 
done smoothly and gently; whereas, if a stretcher 
is laid alongside of an injured person, some of those 
who lift him will have to step backward over it, and 
in doing so may stumble. One person should, if 
possible, give his whole attention to supporting the 
injured part when a person is put upon a stretcher. 
A stretcher should not be carried on the shoulders, 
but should be held with the hands or supported by 
straps passing over the shoulders of the bearers. The 
bearers should also march in broken step and not 
"keep time." In going up hill the patient's head 
should be in advance, in going down hill, his feet. 



94 



ACCIDENTS AND EMERGENCIES. 



If a limb is crushed or broken, it may be laid upon a 
pillow, with bandages tied round the whole, so as to 
keep it from slipping about (see page 57). Where an 
injured person can walk, he can get much help by 
putting his arms over the shoulders and round the 
necks of two others. In case of an injury, when walk- 
ing is impossible and lying down is not absolutely ne- 





Fig. 13. 



Fig. 14. 



cessary, an injured person may be seated on a chair and 
carried, or he may sit upon a board or fence rail, the 
ends of which are carried by two men, around whose 
necks he should place his arms, so as to steady him- 
self; or two men may carry him seated on their inter- 
locked hands, in the way known to children as " Lady 



TRANSPORTATION OF INJURED PERSONS. 95 

to London." For this, each of two persons, stand- 
ing face to face, should grasp his right forearm with 
his left hand (its back uppermost), then he should 
grasp his companion's free left forearm with his own 
free right hand (also with its back uppermost) as 




Fig. 15. 

shown in Fig. 13. When no litter can be obtained, 
the body may be supported by a man on each side, 
with their arms placed behind his chest and under his 
hips, as in Fig. 14. Another mode of carrying an 
injured person is that shown in Fig. 15. One man 



96 ACCIDENTS AND EMERGENCIES. 

passes his arms from behind under the armpits and 
clasps his hands over the chest of the injured person, 
and raises him from the ground, while another 
carries one leg over each of his own arms. 

In carrying an injured person upon a litter, or 
what serves for one, the bearers, as stated above, 
ought not to keep step; but when they are not 
using a litter, they should keep step. 



poisons. 97 



Poisons.* 



Immediately upon the discovery or suspicion of 
poisoning, some one should be dispatched for a doc- 
tor, if possible, carrying information as to the poison 
taken, so that valuable time may be saved. Mean- 
while the following may be done. 

Unknown Poisons. If vomiting has set in, 
this should be encouraged ; if not, it must be pro- 
voked. The simplest way to do this is to give large 
draughts of lukewarm water, and to tickle the throat. 
A teaspoonful or two of ground mustard, or a tea- 
spoonful of powdered ipecac, or a tablespoonful of 
the syrup of ipecac may be stirred up in the water. 
Further, let it be remembered that there is no occa- 
sion for fastidiousness. Any water will do. Water 
in which hands — or dishes, for that matter — have 
been washed may, by its very repulsiveness, act 
more quickly than anything else \ and if soap has 
been used, it will be all the better for that, as soap is an 
antidote for many poisons. The quantity used must 

* It is better to prevent accidents than to correct them. It is a good plan 
to have dangerous articles kept invariably out of reach of children, and to 
have any bottle containing what may be dangerous marked by a ball and 
chain, such as the druggists sell, or by tying a stout piece of tape round its 
neck. This gives warning in the dark as well as in the light. 



98 ACCIDENTS AND EMERGENCIES. 

be large \ the sufferer must be urged to drink and 
drink, a large quantity at a time, and be made to 
vomit several times — not pushing this to exhaustion, 
however. 

After copious vomiting, soothing liquids should be 
given — oil, milk, beaten-up raw eggs, or flour and 
water — all in moderately large quantities. These 
are especially valuable when the poison has been of 
an irritating character. 

If the sufferer be much depressed in body or mind, 
the hands and feet cold, the lips blue, the face pale, 
a cold perspiration upon the forehead and about the 
mouth, then some stimulant may be administered. 
Strong, hot tea, without milk, is the best, because it 
is a chemical antidote to many poisons. Strong 
coffee is next in value. To either of these can be 
added brandy, whisky, . wine, or alcohol, in tea- 
spoonful doses for an adult and half as much for a 
child. Or the spirits may be given mixed with a 
little hot water. Warm coverings are not to be for- 
gotten ; and if the depression be great, hot water-cans 
or hot bricks, wrapped in one or two thicknesses of 
blanket, should be laid by the side of the chest, or a 
huge poultice placed round the body, or a blanket, 
wrung out of hot water and covered with a dry one. 
(See " Shock. ") 

Oil of Vitriol {sulphuric acid) and Nitric and 
Muriatic Acids are heavy, sometimes yellowish- 
looking, fluids; the first, as its name implies, not 



poisons. 99 

unlike oil in appearance, but very heavy in a bottle. 
The others are lighter, and give off extremly pun- 
gent, irritating fumes. All discolor anything on 
which they fall ; the first blackens white pine wood, 
and others turn it yellow. All burn horribly and 
leave no doubt of their caustic nature. 

For these the proper treatment is to give an alkali. 
A tablespoonful of hartshorn may be mixed with two 
teacupfuls of water, and given ; or large quantities of 
baking or washing soda, magnesia, potash, whitewash, 
chalk, tooth-powder, whiting, plaster, soap, or even 
wood ashes, stirred up in water. 

In poisoning with acids vomiting should not be 
provoked, because there is no need to bring back the 
acid if it has been fully neutralized, and there is no 
use in doing so if it has not been. After using the 
alkaline antidote, the bland fluids mentioned above 
may be administered, and rest secured and stimula- 
tion employed, if necessary. 

Oxalic Acid comes in small, heavy, bright, color- 
less crystals, making a clear, rattling sound when 
shaken in a bottle or jar. For this the best antidote is 
lime in some form. If lime-water* is at hand, it may 
be given freely, or whitewash, tooth-powder, chalk, 
whiting, or plaster from a wall. The latter may be 
crushed and stirred up in water, without regard to the 
grittiness, which will not do any harm. 



* Lime-water may be made in an emergency by putting a piece of lime 
about as large as a walnut in a pint of water and shaking them well 
together for a few minutes. 



100 ACCIDENTS AND EMERGENCIES. 

Prussic Acid is usually immediately fatal. The 
cyanide of potash (used by photographers) and oil of 
bitter almonds are poisonous because of the prussic 
acid they contain. Poisoning with either of these 
must be treated with an emetic and with bland liquids 
and stimulants. Hartshorn may be inhaled from a 
handkerchief. 

Carbolic Acid and Creasote are usually in so- 
lution, as a thick, clear, pink, or dusky fluid. When 
taken by the mouth they cause whitening and shrivel- 
ing of the mucous membrane lining it, with intense 
burning, and then numbness. There are also nausea, 
weakness-, depression, and sometimes actual collapse. 
They are very dangerous poisons, because they act 
as caustics and also benumb the stomach, so that it 
is hard to provoke vomiting. This must be at- 
tempted, however, and Epsom salts (a tablespoonful 
for an adult) should be given dissolved in water, 
followed by large draughts of oil, white of egg, 
magnesia and water, or milk. Rest, warmth of the 
body, and stimulation must also be secured if there 
is depression. 

Alkaline Poisons. — The strong alkalies are am- 
monia, or hartshorn — which is a clear fluid with an 
unmistakable odor — potash and soda, usually dis- 
solved, and sometimes in the form of lye. Liniments 
containing these substances are sometimes swallowed 
by mistake. 

The alkalies usually burn intensely. They must 



POISONS. 101 

be combated with an acid. Vinegar can generally 
be had ; and there is nothing better. It should be 
given undiluted and freely — a half teacupful at a 
time. Lemon juice may be used, or even orange 
juice ; though the latter is too mild an acid to be 
of much service, unless the oranges are very sour. 
Vomiting may do harm if pushed too far ; and this 
part of the treatment may well be left to nature. 
Bland acid or oily drinks may be given, and rest 
and stimulation secured if necessary. 

Arsenic is a white, sweetish powder, and is used 
in fly-papers and powders, to destroy domestic pests, 
such as rats, bugs, and roaches. It is also found 
in some paints and in wall-paper or glazed toy-papers. 
It usually excites vomiting and violent pain in the 
stomach. At once large quantities of milk, white of 
egg, flour and water, oil, or lime-water must be given. 
The vomiting must be encouraged or provoked, and 
dialysed iron given. This can now be obtained at any 
drug store, and should be given freely, in tablespoon- 
ful doses, each dose being followed at once by a tea- 
spoonful of common salt in a teacupful of water. If 
it is not at hand, equal parts of sulphate of iron (green 
vitriol) and of carbonate of soda may be dissolved in 
separate cups of hot water and then mixed and drunk. 
Afterward vomiting should be again provoked, and 
followed by a dose of castor oil. 

Paris Green and Fowler's Solution are 
arsenical preparations. If taken as a poison, the 



102 ACCIDENTS AND EMERGENCIES. 

treatment is the same as for poisoning with simple 
arsenic. 

Sugar of Lead comes in white lumps or powder. 
Poisoning with lead is to be treated with vomiting, 
Epsom salts, milk, eggs, and castor oil. 

Corrosive Sublimate (bichloride of mercury) 
comes in small, colorless crystals, or in a clear solu- 
tion ; it is also contained in most of the " antiseptic 
tablets" used in making washes and dressings for 
surgical cases. For corrosive sublimate poisoning, 
vomiting must be provoked and some form of tan- 
nic acid given. Strong tea is the handiest thing 
containing this, and its administration should be 
followed by giving eggs and milk or flour and water 
freely. 

Tartar Emetic, a white powder, is best treated 
in the same way. 

Phosphorus is found in the heads of matches, 
and it is contained in some rat-poisons. It is a 
poison which acts slowly, and affords ample time for 
securing medical advice. But five-grain doses of 
sulphate of copper, dissolved in water, maybe given, 
at intervals of ten minutes, until vomiting comes on. 
Half-teaspoonful doses of old oil of turpentine are said 
to be very useful in poisoning with phosphorus. Then 
a dose of magnesia should be administered ; but no oil. 

Croton Oil is sometimes contained in liniments. 
It produces great pain in the stomach with griping 
and purging, and depression. It should be treated 



POISONS. 103 

with an emetic, if recently taken, and bland liquids, 
like oil or white of egg, and the administration of 
stimulants and of some laudanum or paregoric if 
necessary. 

Lunar Caustic (nitrate of silver) is sometimes 
swallowed. The antidote for this is a strong brine 
of salt and water, given again and again ; and vom- 
iting should be provoked until the vomited matters 
cease to have a look like thin milk. Afterward a 
dose of castor oil may be given. 

Iodine, in the form of a tincture, is also some- 
times swallowed by mistake. The antidote for this 
is starch and water, or plenty of milk, or flour and 
water. 

Opium Preparations are opium, morphine, laud- 
anum, paregoric, black drop, chlorodyne, some lini- 
ments, and many nostrums sold as soothing-syrups, 
pain-destroyers, and drops for infants. Opium pro- 
duces deep sleep, with narrowing of the pupil of 
the eye to a small circle, which does not enlarge in 
the dark. Here emetics must be used promptly and 
persistently, and vomiting produced over and over 
again. Strong coffee must be freely given as a 
stimulant. So long as the breathing does not fall 
below ten to the minute there is no immediate 
danger of death ; but opium is a treacherous poison, 
and requires all the skill that can be obtained to 
combat it. The important matter is to keep up the 
breathing. The custom of walking a patient up and 



104 ACCIDENTS AND EMERGENCIES. 

down and slapping him with wet towels is to be 
deprecated, because it adds exhaustion to stupor. 
If an electrical battery can be obtained and used, 
it is the best thing that can be done. The Faradic 
current should be used, and applied so as to stimulate 
the sensory nerves in the skin, so that they shall ex- 
cite reflex acts of deep breathing. The next best 
thing to lay the patient upon a lounge and slap his 
skin from time to time with the back of a broad 
brush or with a slipper. This is all the rousing that 
is necessary as long as the breathing keeps above ten 
to the minute. Should it fall below this, or if the 
breathing should cease, artificial respiration should 
be employed. (See page 14.) 

Chloral is a damp, colorless, crystalline substance, 
usually seen in solution. Its symptoms and treat- 
ment are similar to those of opium. 

Belladonna, or its active principle, Atropia, is 
so much used in medicine that accidents sometimes 
occur from its misuse. Symptoms of poisoning with 
belladonna are a dilated pupil, a peculiar flush of the 
face, dry throat, unsteadiness of gait, and delirium. 
The treatment consists in giving an emetic, followed 
by rest, warmth to the extremities, and a moderate 
quantity of strong coffee. 

Strychnine is an intensely bitter, white powder. 
It produces stiffness of the jaws, then of the limbs 
and body. It should be treated by provoking vomit- 
ing, giving a purge, and doses of thirty grains of 



POISONS. 105 

bromide of potash, or twenty grains of chloral, or 
both, to an adult, and one-quarter as much to a child 
for each five years of its age. The greatest quiet must 
be secured. The poisoned person should be put to 
bed in a darkened room, with doors, windows, and 
shutters arranged in a way that shall exclude all 
sights, sounds, and draughts, though permitting as 
good ventilation as possible. 

Aconite and Veratrum Viride are sometimes 
contained in liniments, and in this way come to be 
swallowed by mistake. In such a case vomiting 
must be brought on, and followed by the adminis- 
tration of stimulants. Strong coffee may be used, 
hartshorn (a teaspoonful in a teacupful of water), 
wine, whisky, or brandy. The patient will often 
feel a peculiar numbness or tingling in the arms or 
legs, which is an evidence that the poison has entered 
the blood, and makes the attention of a physician 
imperative. If there is depression, warmth should 
be used, as described when speaking of unknown 
poisons. 

Hemlock, Deadly Nightshade, Jamestown 
(or Jimson) Weed, Monkshood, and Toad- 
stools are sometimeseaten without knowledge of their 
poisonous character. Tobacco, Indian Tobacco, 
Poison Sumac, and other plants sometimes cause 
poisonous effects. Nightshade, Jamestown weed, 
and monkshood produce widening of the pupil and 
some delirium — usually of a laughing sort — and often 

H 



106 ACCIDENTS AND EMERGENCIES. 

a disposition to pick at imaginary objects, but no 
sleepiness. All are likely to produce deep depression, 
and must be treated with vomiting, followed by 
stimulation and warmth, very much as in the case of 
belladonna poisoning. 

Alcoholic Liquors are sometimes taken in such 
large quantities as to be poisonous. When this is 
the case there are evidences of deep stupor or de- 
pression. The course to be pursued is to cause 
vomiting, give hartshorn and water (a teaspoonful in 
a teacupful), and keep the body warm. (See "In- 
toxication." Page 38.) 

Decayed Meats or Vegetables usually excite 
vomiting, which should be encouraged until the 
stomach is empty, and followed by a dose of castor 
oil and a teaspoonful of powdered charcoal. 

Recapitulation. We have now completed the list of 
poisons that are at all common, and have seen what 
should be done in almost any case that is likely to 
occur. In conclusion, let it be remembered that, 
when there is an alarm of poisoning, some one, at 
least, must keep cool ; then that a physician is to be 
summoned (sending him word, if possible, what 
poison has been taken) ; and that, until his arrival, 
the course indicated above should be followed. An- 
other thing which may be remembered is that acci- 
dental poisoning is very rarely fatal. In seventeen 
years of practice the author has never seen a case of 
accidental poisoning in which the patient did not 



POISONS. 



107 



recover. So, in case of poisoning, the treatment here 
suggested may be followed, and it may generally be 
expected that the patient will get well. To save 
time in an emergency, the following table may be 
consulted, which gives the name of each poison we 
have already studied and the proper treatment for it. 



POISON. TREATMENT. 

( Emetic, 

Unknown < Bland liquids, 

(. Stimulation. 
Acids — 1 f An alkali, 

Sulphuric, | j Bland liquids, 

Nitric, | j Rest, 

Muriatic. J [ Stimulation. 

( Emetic, 

Oxalic Acid < Chalk, 

( Bland liquids, 
f Emetic, 

Carbolic Acid, \ SPTi — S' 

Creosote. j \ ^liquids, 

[ Stimulation. 
Prussic Acid — ~| ( Emetic, 

Oil of almonds, > -< Bland liquids, 

Cyanide of potash. ) ( Stimulation. 

Alkalies — ") r . . , , . , 

Hartshorn, [ £ n acid (vinegar), 

Soda, L \ |land liquids, 

L ' [ Stimulation. 

Arsenic— ~\ [ Emetic > 

Paris green, J J?ialysed iron and salt, 

Scheele's green, \ \ pastor oil, 

Fowler's solution. J c * • 1 ♦ • 

J y Stimulation. 

f Emetic, 

J Epsom salts, 

j Bland liquids, 

I Castor oil. 



Sugar of Lead.. 



Corrosive Sublimate, 
Tartar Emetic. 



) I 



f Emetic, 

Strong tea, 

Raw eggs and milk, 
j Castor oil, 
L Stimulation. 



108 ACCIDENTS AND EMERGENCIES. 



POISON. TREATMENT. 

f Emetic, 

Phosphorus \ | l i P p h e a n \ e in ° e f C ° Pper ' 

[ Magnesia, but no oil, 
( Emetic, 

Croton Oil -< Bland liquids, 

( Laudanum or paregoric, 
f Salt and water, 
Lunar Caustic \ J Castor oil, 

(nitrate of sil ver). j j Bland liquids 

[ Emetic. 
( Emetic, 

Iodine < Starch and water, 

( Bland liquids. 
Opium — "] 

Morphine, f Emetic, 

Laudanum, )■ < Strong coffee, 

Paregoric, etc. | ( Keep up breathing. 

Chloral. J 

Belladonna— \ J w™ 6 ^ 

f Emetic, 

Strychnine - ■< Purgative, 

(. Absolute quiet. 

Aconite, \ j S^V 

VeratrunViride.) \ H^dtow"' 

Jamestown Weed, ~\ 

Hemlock. , ^ 

Nightshade, \ J a? etl ?\- 

Toadstools, I Stimulation. 

Tobacco, etc. J 

Alcohol { |"5g=- . f 

( Hartshorn and water. 

Emetic, 
Decayed Meat or Vegetables. -^ Purgative, 

Powdered charcoal. 



«■{ 



To provoke vomiting, warm water may be used 
with or without ground mustard (a tablespoonful to 
a pint of water), or ipecac (a teaspoonful of the 
powder or a tablespoonful or so of the syrup), and 
thrusting a finger down the throat — not too far, how- 



POISONS. 109 

ever. It is best to give large quantities (that is, a 
pint at a time) of warm water whenever vomiting is 
to be excited. 

Bland liquids are milk, raw eggs, some sort of 
oil, gruel, flour and water, etc. 

Stimulants are tea, coffee, whisky, wine, etc., or 
hartshorn. Of the last, a half teaspoonful in a tea- 
cupful of water will be enough for a dose. In making 
tea or coffee, one must not wait to do it as if for the 
table, but mix hot water and the leaves, or grounds, 
squeeze them well, stir together, and give the whole 
— leaves, grounds, everything. At the same time 
some may be made regularly, if there are conve- 
niences for it. 

Alkaline antidotes are hartshorn and water (a 
tablespoonful in two teacupfuls of water), soap and 
water, lime, whiting, soda, chalk, tooth powder, 
plaster, magnesia, whitewash, and even wood ashes. 

Acid antidotes are vinegar and lemon juice. 

In giving an antidote never wait for it to dissolve. 
Just stir it up in any fluid at hand except oil, and 
have it swallowed immediately. 

When laudanum is advised for such an irritant 
poison as croton oil, it must be given in a dose of 
half a teaspoonful to an adult and a drop for each 
year of a child's age. Such doses may be repeated 
in half an hour if the pain continues to be severe 
and there is no drowsiness. 



110 ACCIDENTS AND EMERGENCIES. 



Description of Poisonous Plants. 



Poisoning is sometimes caused — especially among 
children — by eating parts of certain plants which 
grow wild in the woods or fields, or by the roadsides 
as well. 

A few of these may be described, so that they may 
be avoided if possible, or — in case of accident — that 
it may be known what has done the mischief. 

Bitter-sweet, Woody Nightshade (Solanum 
dulcamara) must not be confounded with the culti- 
vated plant called " bitter-sweet. M The woody 
nightshade is a shrubby, climbing plant, bearing blue 
or purple flowers, with an orange-colored centre, 
and oval, bright red berries, that are poisonous. 

Deadly Nightshade (Atropa belladonna) grows 
three or four feet high, has large, dark green, pointed 
leaves growing on downy stems, with drooping, bell- 
shaped flowers and blue-black berries (when ripe), 
marked with a deep furrow. (Fig. 16.) 

Fool's Parsley (^Ethusa cynapium) grows about 
two feet high in waste grounds, and looks something 
like ordinary parsley (Apium petroselinum), but has 
a disagreeable odor. Its leaves are compound and 
dark green, and its flowers are white. 



DESCRIPTION OF POISONOUS PLANTS. 



Ill 



Foxglove (Digitalis) is a European and Asiatic 
plant, cultivated in gardens in various parts of the 
world. It grows three or four feet high. It has large, 
dull-green, downy leaves and handsome, bell-shaped 
crimson or purple flowers, with beautiful spots within, 
arranged in a " spike. " (Fig. 17.) 



mil A 




Fig. 16. 

Hemlock. — Ground Hemlock, Dwarf Yew 

(Taxus Canadensis), looks like a dwarf spruce tree. 
It is an evergreen, with small red and juicy berries 
(drupes) concave on the summit. The leaves and 
black seeds are poisonous. 



112 



ACCIDENTS AND EMERGENCIES. 



Hemlock. — Poison Hemlock (Conium macu- 
latum) grows from three to six feet high, with many 
branches, the stems of which are smooth, round, and 
spotted with purple. The leaves are compound, and 
bright green. It has small, white flowers, arranged 




sfr 



- "?~c 



J 




in umbrella shape. The plant has a disagreeable 
odor. (Fig. 18.) 

Hemlock. — Water Hemlock, or Spotted 
Cow-bane (Cicuta maculata), is a plant growing 



DESCRIPTION OF POISONOUS PLANTS. 



113 



from three to six feet high, in damp ground, with 
slender, compound, notched leaves, on a hollow 
stem, and small, white flowers, arranged in shape 
like an umbrella. The root is thick and fleshy, and 




Fig. 18. 



very poisonous. The leaves are poisonous, and 
often prove injurious to cattle. 

Henbane (Hyoscyamus) is a plant which grows 
about two feet high, with large, pale-green leaves with 



114 



ACCIDENTS AND EMERGENCIES. 



scalloped edges. The flowers are straw colored, 
rimmed with a purple, urn-shaped cup. (Fig. 19.) 
Indian Tobacco (Lobelia inflata) grows about 




Fig. 19. 



two feet high, with a, rough, straight stem, pointed, 
notched, and hairy leaves, with small, pale blue 



DESCRIPTION OF POISONOUS PLANTS. 



115 



flowers springing from the junction of a leaf-root 
with its stem. 

Indian Turnip, or Jack in-the-Pulpit (Arum), 
grows about a foot high, with a peculiar flower on 
a straight stem, with scarlet berries. The root is 
turnip-shaped and has a burning taste. 




Fig. 20. 



Jamestown or "Jimson" weed, Thorn- 
apple (Stramonium), grows about three or four 
feet high, with tough skin, ragged leaves, and a 
white or tinted flower like a very tall, slender vase. 
A peculiar feature of the Jamestown weed is the seed- 
pod, which is green when young and gray-brown 



116 ACCIDENTS AND EMERGENCIES. 

when mature and dry. It is very rough and thorny 
outside and contains seeds that are soft and white 
when young, and become hard and black when old. 
(Fig. 20.) 

Monkshood (Aconitum napellus) is a native of 
the ' mountainous parts of Europe and Asia. It 
grows about four feet high, with leaves deeply cleft 
into five parts. Its flowers are dark blue, with a 
vaulted upper sepal, like a monk's cowl. They are 
arranged in the form called a spike — several flowers 
along a common stem. 

Poison Ivy, Poison Oak (Rhus toxicodendron) 
is a climbing shrub sometimes confounded with 
the Virginia creeper. It is distinguished from the 
latter by having its leaves arranged in clusters of 
three, while those of the Virginia creeper are in 
clusters oi five. Its berries (drupes, botanically) are 
dull white, while those of the Virginia creeper are 
dark blue. The poison-ivy causes a painful, itching, 
and very troublesome eruption in some people when 
it is touched, or even when it is approached. 

Poison Sumac (Rhus venenata) grows ten or 
fifteen feet high, with wide, spreading branches, 
leaves three inches long and about half as wide, with 
long, red stems and small, greenish flowers, with fruit 
like a cherry (drupe) but the size of a pea. The 
whole plant is very poisonous to taste or touch and 
has a very disagreeable odor. 

Poke-berry (Phytolacca decandra) is a very 



DESCRIPTION OF POISONOUS PLANTS. 



117 



common shrub in North America, growing from four 
to eight feet high, with a smooth stem, often of a 
deep purple color, with greenish-white flowers, and 




Fig 



clusters of dark purple berries at the end of delicate 
stems. The plant is not very poisonous, but may 
cause dimness of vision and even convulsions. 

Poke-root, Indian Poke, Hellebore (Veratrum 



118 ACCIDENTS AND EMERGENCIES. 

viride, V. album) grows from three to six feet high, 
with large, coarse, oval, pointed leaves, with straight 
veins, with many small, green flowers, arranged at the 
top of the stem on little branches (panicle). It is 
an exceedingly poisonous plant. (Fig. 21.) 

Wild Parsnip (Pastinata sativa) is a plant about 
three feet high, with compound leaves made of small 
leaflets arranged along a grooved stem; they are 
dark green, and downy on the under side. The 
flowers are yellow and grow in small clusters. The 
root is tapering, like that of the cultivated parsnip. 
The root of the wild parsnip, unlike that of the food 
parsnip, has a harsh and bitter taste. 

Wolfs-bane (Aconitum uncinatum) grows wild 
in parts of the United States. It is a plant about 
two feet high, with dark green leaves divided into 
three or five points (palmate), and with three or four 
large purple flowers at the end of each branch. 



DOMESTIC EMERGENCIES. 119 



Domestic Emergencies. 



No less important than the emergencies thus far con- 
sidered, most of which have a sort of public signifi- 
cance, are a few more which usually occur within 
the limits of the household, and try the knowledge 
and patience of anxious parents. If these emer- 
gencies arose only when skilled assistance could be 
had in a moment, their consideration might be omitted 
from a book like this. But they have a way of pre- 
senting themselves at the dead of night, in travel- 
ing, at the seashore, or in the mountains, where 
doctors are not known or are not to be had 
promptly; and those upon whom the burden of 
meeting them falls may be glad to have some 
simple suggestions as to what they may do until they 
can commit their interests to others better prepared 
to guard them. 

Cholera Morbus produces vomiting and purging 
and violent cramps in the stomach. The pain may 
be so severe as to actually threaten life. There is 
then a pinched expression of the face, and a cool, 
clammy skin. In such cases, something must be done 
at once to relieve the pain. For this, laudanum 
may be given — half a teaspoonful to an adult, and 



120 ACCIDENTS AND EMERGENCIES. 

to a child a drop for each year of its age. At the 
same time heat must be applied to the stomach. 
For this purpose a mustard plaster can be used, or 
cloths wrung out of hot water and sprinkled with 
turpentine or with red pepper, or a hot-water bag, 
or bottle, or a plate heated at the fire and covered 
with a cloth. An injection composed of a small tea- 
cupful of warm water or milk, to which a tablespoonful 
of tincture of asafoetida has been added, often gives 
great relief. 

Colic causes violent griping pain in the abdomen. 
It is usually due to something indigestible that has 
been eaten. It should be treated with hot applica- 
tions to the abdomen, such as have just been men- 
tioned. A purgative, such as castor oil or castor oil 
and spiced syrup of rhubarb, may be given by the 
mouth, and an injection of water and asafoetida 
administered, as described in speaking of cholera 
morbus. 

Vomiting, or Nausea, due to something ob- 
jectionable in the stomach, may be treated by giving 
large draughts of pretty hot water. If it be due to 
nervousness or a slight indigestion, it can usually be 
corrected by swallowing small pieces of ice, or table- 
spoonful doses of lime water, or a pinch of soda, or 
half a teaspoonful of aromatic spirits of ammonia in 
a wineglassful of cold water, together with the applica- 
tion to the pit of the stomach of a mustard plaster, 
or of a flannel cloth wrung out of hot water and 



DOMESTIC EMERGENCIES, 121 

sprinkled with a tablespoonful of turpentine or some 
red pepper. A lump of ice held against the pit of the 
stomach sometimes does much good. The sufferer 
should, if possible, lie down until the nausea passes 
off. 

Diarrhoea is usually due to a cold or to something 
indigestible which has been eaten. In either case it 
is an effort of nature to cure itself of something hurt- 
ful. So, at the start, the best thing to be done is to 
give a mild purge. It is a good plan to give a tea- 
spoonful or two of a mixture of equal parts of olive 
oil and castor oil to an infant, and a tablespoonful or 
two to an adult. Half these quantities of a mixture 
of glycerine and castor oil acts equally well. 
Nothing acts better for adults or infants than a tenth 
of a grain of calomel, given every half hour till it 
produces a free movement. A teaspoonful of a mix- 
ture of equal parts of sweet oil and castor oil, or of 
spiced syrup of rhubarb and castor oil, for an infant, 
and two tablespoon fuls of the same mixture. for an 
adult, is often very useful. After this, if the move- 
ments of the bowels soon return, half a teaspoon- 
ful of ginger in a wineglassful of water may be given 
to an adult after every passage. If this does not 
check the diarrhoea, ten drops of laudanum may be 
given to an adult after each passage. For an adult, 
also, an injection, made of half a small teacupful of 
boiled starch, to which thirty or forty drops of laud- 
anum have been added, often gives immediate relief, 
i 



122 ACCIDENTS AND EMERGENCIES. 

For a child over two years old, half a drop of laud- 
anum may be given after each passage, until the 
diarrhoea seems checked or there is some evidence 
of drowsiness. A simpler remedy, which often acts 
well, is a tablespoon ful of raw flour in a glassful of 
cool water, to be taken in two doses, half an hour 
apart. 

Dysentery sometimes follows a simple diarrhoea, 
and sometimes comes on suddenly, with fever and 
often with screaming in children. There is a strong 
and constant inclination to have the bowels moved, 
but the passages are usually small, and the movements 
accompanied with severe straining and pain and the 
discharge of some blood. 

The treatment is best begun with a purge of castor 
oil and rhubarb. Then laudanum may be given 
by the mouth (half a teaspoonful to an adult, and to 
a child a drop for each year of its age). Great relief 
is sometimes afforded by large injections of cold 
water very slowly and gently given, or small injec- 
tions of thin boiled starch (six tablespoonfuls for an 
adult and one for an infant), with laudanum in the 
same dose as when it is given by the mouth. Rest 
in bed and liquid food are indispensable parts of the 
treatment. 

The discharges from the bowels ought to be disin- 
fected by adding boiling water to them or chloride 
of lime. The vessels used should also be scalded 
after every emptying. 



DOMESTIC EMERGENCIES. 123 

Croup. Attacks of spasmodic croup, though 
very alarming, are rarely dangerous. There is- prob- 
ably much less real croup than is supposed, and the 
hoarse cough which children sometimes have after 
taking cold may lead to measures which make it 
much worse for all concerned. Parents need not get 
excited when they hear what is called a " croupy " 
cough. When it occurs, they should first see what 
can be accomplished by allaying the alarm of the 
child and by diverting its mind. The reading of 
some favorite story or the exhibition of a favorite 
toy may cause all the symptoms of croup to 
disappear. 

When such mild measures are of no avail, and the 
symptoms become more urgent, the little sufferer 
should be given an emetic of a teaspoonful of syrup 
of ipecac or a heaping teaspoonful of powdered alum, 
followed by a draught of warm water. After the at- 
tempt at provoking vomiting it is well to give a purge 
like castor oil and spiced syrup of rhubarb. Cloths 
wrung out of water as hot as can be borne should be 
wrapped round the throat and laid upon the chest. 
They should then be covered with something to 
keep the heat in — like oiled silk or a dry cloth. 

This is all that can ordinarily be done with ad- 
vantage until a physician arrives. But it usually gives 
decided relief. In this case, and even if it does not, 
natural anxiety should not drive parents to be want- 
ing to do something else all the time. They may 



124 ACCIDENTS AND EMERGENCIES. 

renew the hot cloths as soon as they begin to grow 
cold, but besides this there is nothing to be done but 
to wait until there has been time for the spasm to pass 
off. This is hard to do, it is true ; but it is the best 
thing to be done, and far better than the fuss and 
worry, to parents and child, of trying a variety of 
methods. 

Whooping Cough. Children with whooping 
cough should go out in fine weather ; in bad weather 
they should be kept in a well-ventilated room in a 
warm and (if possible) moist atmosphere. Moisture 
can be secured by having a flat vessel containing 
water upon the stove, or by putting a basin of water 
on a chair in front of a register and hanging a long 
towel over the back of the chair with one end in the 
water. The towel may be dipped in the water from 
time to time as it becomes dry. In whooping cough, 
the bowels should be kept open, and only good, 
digestible food should be given. A belladonna 
plaster on the chest sometimes does good, and if the 
paroxysms of coughing are very severe, some form 
of opium may be given. Ten drops of paregoric 
may be given to a child two years old and repeated 
in an hour. A child six years old should have half a 
teaspoon ful at a dose. 

In whooping cough there is a strong nervous ele- 
ment, and a spasm of coughing is often brought on 
by the example of another child. So, when a child 
is seized with a fit of coughing, it ought, if possible, 



DOMESTIC EMERGENCIES. 125 

to be at once separated from other children, for its 
own good and for theirs. 

Asthmatic Attacks may be treated in several 
ways. One method is founded upon the fact that asth- 
ma is a nervous manifestation, which grows worse the 
more the attention is directed to it. If the attention 
can be diverted, the attack will often pass off. Oc- 
curring, as it usually does, at night, the darkness, the 
surprise, the absence of surrounding activities, in- 
crease its effects. If the sufferer be a man, and will 
get out of bed, put on his gown and slippers, light 
his gas, and take a book or paper and begin to read, 
he will, in many cases, soon find his trouble dimin- 
ishing and finally disappearing. If he be a smoker, 
his cigar or pipe will help him in this emergency. 

A less agreeable method is to take an emetic. 
Another is to smoke the asthma cigarettes sold in 
every drug store. Another is to get some steaming 
hot water in a basin, pour into it a tablespoonful or 
more of Hoffman's anodyne, and breathe the ascend- 
ing vapors. One of the best remedies is a full dose 
of opium in some form — for an adult, thirty drops of 
laudanum or a tablespoonful of paregoric. As soon 
as this takes effect, the spasm of asthma will disappear. 

Nervous Attacks, which may take the form of 
shivering fits, are to be treated by putting the patient 
to bed, if possible, and giving some hot coffee or 
hot sweetened water, and by applying heat to the 
body by means of a bath or hot cloths or bottles, 



126 ACCIDENTS AND EMERGENCIES. 

with a mild mustard plaster or turpentine placed on 
the pit of the stomach. A teaspoonful of camphor 
water, of valerian, or of Hoffman's anodyne will 
often prove of great service. 

Toothache, depending upon a cavity in a de- 
cayed tooth, is usually very easy to stop. To do 
this a fine crochet needle or a knitting needle should 
have a very small bit of clean cotton twisted round 
its point, and with this the hole in the tooth should 
be thoroughly cleaned out. Then the point of the 
needle should be cleaned and another little ball of 
cotton, like a very small shot, should be dipped in 
oil of cloves and caught up with the end of the 
needle. It should then be laid in the hollow tooth 
and pushed in, not too hard, with the end of the 
needle. This rarely fails to cure such a toothache. 
Sometimes filling the cavity with baking soda, after 
cleaning it thoroughly, will stop the pain. 

When toothache is not due to a hollow tooth, a 
somewhat severe, but usually efficient, plan of treat- 
ment is to lay between the gum and the cheek a 
little wad of cotton, the size of the end of the 
thumb, soaked in spirits of camphor. This makes a 
sort of blister, but generally cures the toothache, 
which is much harder to bear. 

Earache should always suggest an examination 
of the teeth, and if one be found decayed, it may be 
extracted, or at least cleaned out and packed with 
cotton and oil of cloves, as described in speaking of 



DOMESTIC EMERGENCIES. 127 

toothache. Many earaches depend upon a diseased 
condition of the throat or back part of the nose, and 
these should always be investigated in case of ear- 
ache. 

For the pain of earache, a folded cloth, wrung out 
of hot water, with a teaspoonful of laudanum poured 
over it, or a big, hot poultice — for which hops is 
the best material — should be applied to the side 
of the head and kept as hot as possible. Hot 
drinks should be given also, and, if necessary, pare- 
goric or laudanum to give relief from pain. It 
is a good plan to pour into the ear a few drops of 
sweet oil, quite hot (not hot enough to burn, of 
course), to w r hich an equal part of laudanum has 
been added after the oil has been warmed. 

The occurrence of an earache should always lead 
to consulting a doctor, for it is often of importance 
as a sign of disease which may seriously affect the 
hearing. 

Poisoning by the common Poison Vine 
causes red blotches, and wheals, and blisters on the 
skin, with great burning and itching. It is best 
treated by applying cloths soaked in a solution of 
soda, a tablespoonful to a teacupful of hot water. 
Dusting with magnesia or ordinary toilet powder is 
also grateful. 

Neuralgia of the Face may come on suddenly, 
when the advice of a physician cannot be obtained. 
In such a case the application of a hot cloth, wet or 



128 ACCIDENTS AND EMERGENCIES. 

dry, may do much good, or painting the painful part 
lightly with oil of peppermint. On the other hand, 
cold applications may do more good, although this 
does not often happen. 

Convulsions, from various causes, are to be 
treated as described at page 36. 

Fever. It often happens that children unex- 
pectedly develop symptoms of fever when there is 
no physician at hand. In such cases, it is well to 
know what may be done before medical advice can 
be obtained. The first thing to do is to get such a 
child undressed and to give it all the cool water it 
desires to drink. Then a purge should be given, 
nothing being better than a mixture of equal parts 
of castor oil and spiced syrup of rhubarb, or a tenth of 
a grain of calomel every half hour. At the same 
time a teaspoonful of sweet spirits of nitre may be 
put in a glassful of cool water, and a dessertspoonful 
of this mixture may be given every fifteen minutes 
or half hour. This acts gently on the skin and kid- 
neys, and often does much good. 

A feverish child ought not to be covered up too 
warm in bed. It will not " take cold M if it is kept 
moderately cool, and it will be much more comfort- 
able. Nature prompts persons in the heat of fever to 
get rid of most of their covers; and nature is a pretty 
safe guide in the treatment of disease. 

For food, a feverish child should be given nothing 
but milk at first, and nothing at all if it does not 



DOMESTIC EMERGENCIES. 129 

want to eat. Coolness (not coldness, of course), 
plenty to drink, nothing to eat, and a good cleaning 
out of the bowels are the things most important 
for cases of simple fever. Many fevers disappear 
promptly under this treatment, and no case of serious 
fever is prejudiced by it. 



130 ACCIDENTS AND EMERGENCIES. 



Supplies for Emergencies. 



The suggestions in the preceding pages have been, 
as far as practicable, such as could be carried out 
without having made any special provision for them. 
Nevertheless, occasionally appliances and remedies 
have been mentioned which would very much facili- 
tate the treatment if they were accessible. 

Emergency Case. 

A surgical case suitable for almost any emergency 
should not contain so many things as to confuse one 
who has not a medical education. Its supplies 
should be few and simple, such as — 
i. Absorbent cotton. 

2. Roll of old muslin or linen and one of soft 
flannel. 

3. Bandages, 2j4 inches wide and 6 yards long, 
rolled up. 

4. Rubber adhesive plaster, on a spool, in a strip 
two inches wide. 

5. Oiled silk. 

6. Sharp scissors. 

7. Pins (ordinary and small safety pins). 

8. Needles, threaded with stout thread — white. 



SUPPLIES FOR EMERGENCIES. 131 

9. Cosmoline or vaseline. 

10. Alum. 

11. Ammonia — aromatic spirits of. 

12. Calomel. 

13. Castor oil. 

14. Cloves — oil of. 

15. Hartshorn. 

16. Ipecac — syrup of. 

17. Laudanum. 

18. Lime-water. 

19. Mustard. 

20. Nitre, sweet spirits of. 
2i. Paregoric. 

22. Rhubarb — spiced syrup of. 

23. Soda — bicarbonate of. 

24. Turpentine. 

25. Whisky. 

Of medicines, a convenient quantity to have 
is two fluid ounces ; except in the case of oil of 
cloves, of which a fluid drachm is plenty. Aromatic 
spirits of ammonia and hartshorn and the spirits of 
nitre ought always to be kept in bottles having good 
rubber or glass stoppers. 

The laudanum and paregoric bottles, and that of 
the oil of cloves, should be marked Poison / and 
have a tape or small ball and chain attached to their 
necks, so that it could be felt in the dark. 

Each bottle should have its proper dose plainly 
printed or marked on the label. 



132 



ACCIDENTS AND EMERGENCIES. 



For the convenience of readers of this book, the 
author has had made a case containing the remedies 
and appliances named above (except the old muslin). 

This case* (Fig. 22) is made of leather or hard 
wood polished, and measures 11^ X 1% X aY\ 
inches. It contains 20 two-ounce bottles with glass 




Fig. 



stoppers, a glass jar for vaseline, and two spaces for 
surgical appliances. Several of the bottles are left 
unfilled for other articles which may be desired by 
the purchaser. 



* The Emergency Case, with contents, can be purchased of the E. A. 
Yarnall Co., 1020 Walnut Street, Philadelphia, for ten dollars. 



SUPPLIES FOR EMERGENCIES. 133 

USE OF THE EMERGENCY CASE. 

i. Absorbent cotton can be obtained at any 
drug store. It is perfectly clean and soft, and is 
prepared in such a way that it — instead of resisting 
moisture, as ordinary cotton does — will absorb water 
with great rapidity. Thus it will take up discharges 
from wounds ; and when a cool or hot application is 
desired, it can be soaked with cool or hot water. 
Sometimes it is very convenient to put it on dry and 
then squeeze the water upon some part of it from a 
sponge, when every part will rapidly become sat- 
urated.* 

For padding splints, or making cushions to prevent 
pressure of any kind, ordinary cotton is better than 
absorbent cotton. 

2. Old muslin or linen can be torn into any 
shape or size that may be required, and can be used 
to spread poultices upon. It is also useful to make 
broad slings of. 

3. Bandages of the kind described are used to 
keep applications in place, to secure parts to splints, 
and to prevent injurious motion. 

Roller bandages may be made of the follow- 



* Tn buying absorbent cotton, it should always be tested. If good, a lit- 
tle pinch of it dropped on water will become wet and sink in a second or 
two. Cotton which floats dry on the surface is not fresh and is not fit to be 
sold as absorbent cotton. 



134 ACCIDENTS AND EMERGENCIES. 

ing sizes, according to the part of the body for which 
they are required: — 

For the finger, % inch wide and I yard long. 

" arm, 2]/ 2 inches wide and 4 to 6 yards long. 
" leg, 3 inches wide and 6 to 8 yards long. 
" chest, 4 to 5 inches wide and 8 to 12 yards long. 
" head, 2 X / Z inches wide and 4 to 6 yards long. 

The arm-size bandage is the one of most general 
usefulness, and the most convenient to have in an 
emergency case. 

The simplest way to apply a bandage is to make 
circular turns around any part. When the latter is 
of even size, this is a very easy matter. Where the 
part is larger at one end than the other, the ordinary 
circular turns would not fit smoothly. To accom- 
plish this the rule is to begin at the small end and 
make a few turns, round and round, one immediately 
over the other, and then to begin to move up the 
limb spirally. So long as a turn can be made to 
smoothly overlap the one before it about one-third, 
this spiral is all that is required. But as soon as it 
puckers, the bandage is not carried on as before, but 
is turned down, so that the inner face now looks out, 
and the bandage, instead of passing up, passes down- 
ward so as to make a sort of inverted V — so, \. 
On now carrying the bandage round the part, it will 
be found that it comes to the front just overlapping 
the preceding turn, and the same process can be re- 



SUPPLIES FOR EMERGENCIES. 



135 



pcated until the whole bandage is neatly applied. 
(See Fig. 23.) 

At joints, like the ankle, knee, and elbow, the 
bandage may make a sort of figure 8, the middle 
or crossing part being in the bend of the joint, and 
the two loops, one above and one below it. (See 
Fig. 24.) 




Fig. 23. 

Bandages should never be put on so tight as to 
cause pain, and should never be drawn tighter above 
than below. 

Bandages may be fastened with pins, with strips of 
adhesive plaster, by stitching, or by splitting the end 
and carrying one tail on as before and turning the 
other back to meet it and then tying the two to- 
gether. For narrow bandages, the latter is the sim- 
plest plan ; for wide ones some one of the others is 
better. 



136 ACCIDENTS AND EMERGENCIES. 

The width of 2^ inches is that which is oftenest 
convenient. When a narrower bandage is called for 
— as for a finger — one of the former may be torn 
down the middle ; or, if rolled up, it can be laid on 
a firm surface and the whole roller cut in half with a 




Fig. 24. 

razor or a sharp knife, just as one would cut a sau- 
sage. This quickly and easily makes two good fin- 
ger bandages. 

4. Rubber adhesive plaster is better than any 
other kind, because it can be applied without heat or 
moisture. It sticks of itself. When it is to be ap- 



SUPPLIES FOR EMERGENCIES. 137 

plied to a hairy part, the hair should first be shaved 
off, if possible. If not, when the plaster comes to be 
removed, it must be soaked off or it will pull the 
hair out and cause great pain. 

Another point to be remembered is that, in chang- 
ing adhesive plaster dressings, only as much should 
be removed as is necessary or as cleanliness demands. 
The rest may be left on and the new dressing 
applied up to it or over it. In the end all can be re- 
moved together. 

The plaster is most convenient to use in strips, 
which can easily and without waste be cut smaller ; 
while additional strips may be applied side by side 
if a greater width is wanted. 

5. Oiled silk is used to retain heat and moisture 
after poultices or other warm wet dressings are 
applied. 

6, 7, 8. As to the use of scissors, pins, and 
needles, it may be stated that the points of pins 
should never be left sticking out ; and care should 
be used to avoid sticking either pins or needles 
through a patient's skin. 

9. Cosmoline and vaseline are excellent as 
applications to a variety of wounds or injuries, 
though both are somewhat irritating to the eye or 
the inside of the nose. As they never become ran- 
cid, they are preferable to cold cream for an emer- 
gency case. 

10. Alum (in powder) added to water is useful 
J 



138 ACCIDENTS AND EMERGENCIES. 

for checking bleeding from the nose or some forms 
of internal hemorrhage. The dry powder (one 
quarter teaspoonful) is sometimes useful as an emetic 
for children in croup or whooping-cough. 

n. Aromatic spirits of ammonia is a valuable 
stimulant often recommended in the preceding 
pages. It is also useful in acid dyspepsia and nerv- 
ous or sick headache, and simple nervousness. The 
dose is, for an adult, half a teaspoonful in about a 
wineglassful of water ; for a child, ten drops, in 
a teaspoonful of water. This may be given every 
fifteen minutes until four or five doses have been 
taken. 

12. Calomel is admirable as a dusting powder for 
chafing or irritation of the skin, and given internally 
(iV~ J grain every half hour until it acts) is one of the 
very best means of clearing out and putting in good 
shape the bowels. 

13. Castor oil is a most excellent external appli- 
cation wherever an oily or greasy preparation is 
needed. Besides this, it is unquestionably one 
of the very best remedies for an incipient cold, 
and generally useful as a purge. For children (and 
adults, too) it may be made less unpleasant, and 
in some respects improved in action, by the addition 
of an equal part of spiced syrup of rhubarb. A mix- 
ture of these two may be given without much trouble 
to almost any child. It will be found a little easier to 
give castor oil, alone or in combination, if it is 



SUPPLIES FOR EMERGENCIES. 139 

warmed, and then given from a cup or spoon that 
has been heated. 

14. Oil of cloves is used chiefly to cure tooth- 
ache; but a few drops added to a teaspoonful of 
olive oil and rubbed into the skin will often relieve 
the pain of neuralgia in various parts of the body. 
It is also useful in indigestion, in doses of three 
drops for an adult and one drop for a child. This 
may be given rubbed up with a little sugar, or in 
a teaspoonful of sweet oil, or spiced syrup of rhu- 
barb. 

15. Hartshorn is to be used as a stimulant to the 
heart and to the nervous system. A half teaspoonful 
may be put into a tumblerful of water and a table- 
spoonful of the mixture given every few minutes. Its 
use by inhalation everybody is familiar with. Yet it 
may be worth while to say that a bottle of hartshorn 
should never be brought near to a patient's face. 
The stopper may be wetted and held near the nose, 
or a few drops may be put on a handkerchief, or the 
hand, and used in the same way. It is sometimes 
very comforting to put a few drops on a handkerchief 
and fan over this toward a person who is very weak. 

16. Ipecac. The syrup of ipecac is a fairly good 
emetic. But it must be used freely. An adult should 
be given a good tablespoon ful, and an infant as near 
a teaspoonful as possible. It will do no harm ; and 
when an emetic is called for, it is no time to run any 
risk that the dose given may not be large enough. 



140 ACCIDENTS AND EMERGENCIES. 

It is often usefully employed in cases of poisoning, 
convulsions, croup, whooping-cough, or asthma. 

17. Laudanum. Laudanum is the tincture of 
opium, and has all its properties. It is one of the most 
useful drugs in the world, and yet in ftfblish hands it is 
a dangerous one. There need be, however, no fear of 
poisoning with any preparation of opium if ordinary 
doses are given, and if these doses are not given closer 
together than half an hour, and if they are stopped as 
soon as pain is decidedly lessened or drowsiness comes 
on. Occasionally, small doses of opium cause great 
alarm ; but there is much less fear about opium poison- 
ing among doctors now than there used to be. It may 
be considered safe to give thirty drops of laudanum to 
any adult when there is severe pain, and to repeat 
this dose every half hour until the pain is lessened or 
drowsiness begins to appear. One of the signs of 
the effect of opium on the system is a contraction of 
the pupil of the eye, which does not expand in the 
dark — the test being made by shading both eyes, and 
then bringing a light near them. Persistent con- 
traction of the pupil ought always to lead to a dis- 
continuance of any preparation of opium that has 
been used. 

To check diarrhoea, a drop of laudanum given every 
hour will sometimes prove successful very soon. 
Yet ten or fifteen drops may be given to an adult 
after each movement if the smaller quantity does not 
suffice. 



SUPPLIES FOR EMERGENCIES. 141 

For cuts and bruises there is no better application 
than pure laudanum. A soft cloth soaked in lauda- 
num can be bound on, and occasionally wetted with 
it, without removal. It quiets pain and promotes 
healing. A similar application is often very sooth- 
ing in face-ache, tooth-ache, and earache, as well as 
in the pains of rheumatism and neuralgia. 

1 8. Lime-water. Lime water may be prepared 
at any time by putting a piece of lime as large as a 
small apple in a quart or two of water and allowing 
the mixture to stand for a few hours. The clear 
water may be poured off and bottled for use. In an 
emergency a piece of lime as large as a walnut may 
be put in a half pint bottle and the whole well shaken 
for a minute or two. The water may be strained 
through a cloth or allowed to clear by settling, 
according to the degree of haste required. 

Lime water is used to settle sick stomachs, as an 
antidote to acid poisons, and in combination with 
sweet oil as an application to burned surfaces. 

19. Mustard. Ground mustard is useful in plas- 
ters and poultices. In plasters, it should be made 
weaker by the addition of flour — an equal part or 
more of the latter, as the plaster is to be stronger or 
weaker. In adding mustard to poultices, it should 
be first well mixed with water and then stirred into 
the poultice mass. 

Mustard plasters often act quickly and must be re- 
moved in a few minutes, as soon as the skin is well 



142 ACCIDENTS AND EMERGENCIES. 

reddened. Where it is desired to leave a mustard 
plaster on for more than a few minutes, it should be 
made of one part mustard to three or more of flour. 
Every mustard plaster should be removed as soon as 
the skin becomes red, and not allowed to make a 
blister ; because such blisters are excessively painful 
and very hard' to heal. Further, when mustard plas- 
ters are applied to persons who are more or less un- 
conscious, or paralyzed, or of dull intellect, or very 
young, they must not be left on until the patient 
shows uneasiness. In such cases the attendant must 
look at the skin soon and often, to prevent the 
occurence of blistering.* 

20. Nitre. Sweet spirits of nitre is a most useful 
domestic remedy. A teaspoonful may be added to a 
tumblerful of water and a tablespoonful of the mix- 
ture given to an adult, or a dessertspoonful to a child 
of any age, every hour, in any feverish condition. 
This will tend to promote healthy activity of the 
skin and kidneys. 

21. Paregoric. Paregoric is an opium preparation 
which contains, besides opium and other things, 
some camphor. It is the best preparation for child- 



*Red Pepper may sometimes be used instead of mustard ; though it is 
more energetic in its action. When moistened and applied to the skin, red 
pepper first causes a feeling of warmth, and later of intense, fiery burning. 
If left on long enough it will cause a blister. Red pepper well diluted with 
flour may be used in cases of colic or cholera morbus, where it quiets pain 
by its counter-irritant effect, and stimulates the nervous and circulatory 
systems. In nausea it sometimes does good by the latter process. 



SUPPLIES FOR EMERGENCIES. 143 

ren, because the dose is easier to measure than that 
of laudanum. An infant a few hours old will stand 
three drops, and in a few days, five. In a month, 
ten are not too many, and twenty may be given any 
time after six months. An adult can take a table- 
spoonful. It may be used internally in all the cases 
for which laudanum has been recommended. 

22. Rhubarb. The spiced syrup of rhubarb is 
an excellent mild laxative for the bowels. A tea- 
spoonful is the dose for an infant or small child. It 
is useful at the beginning of a diarrhoea in children, 
as it empties the bowels of what irritates them, and 
also has a soothing and healing influence. The use 
in combination with castor oil has been described 
above. 

23. Soda. Bicarbonate of soda (baking soda) 
is useful as an application to burns, as an antidote 
to acid poisons, and for heartburn. For the latter 
the dose is as much as will stand on a silver ten-cent 
piece dissolved in a tablespoonful of water. 

24. Turpentine. Spirits, or oil, of turpentine 
can be used wherever mustard has been recom- 
mended as an external application. For this pur- 
pose a soft flannel or muslin cloth should be dipped 
in turpentine, wrung out nearly dry, laid on the 
surface, and covered with oiled silk or a few thick- 
nesses of dry cloth, to prevent evaporation. 

A milder form of application is what is called a 
" turpentine stupe." This is prepared by sprinkling 



144 ACCIDENTS AND EMERGENCIES. 

a tablespoonful of turpentine over a flannel cloth 
^ folded to several thicknesses) and wrung out of hot 
water. It is in some respects better to stir the tur- 
pentine into a pint of hot water, and then to saturate 
the cloth with it. 

Turpentine is also useful as an antidote to phos- 
phorus poisoning. 

25. Whisky for medicinal use should be of the 
best quality. It should always be used in small doses 
— a teaspoonful for an adult — in hot water, fre- 
quently repeated. 



HOW TO MAKE POULTICES. 

Poultices. The commonest materials for poul- 
tices are hops, bread, flaxseed, and corn-meal. A 
hop poultice is made by pouring hot water upon hops 
until they are well moistened. A bread poultice is 
made by soaking the inside of bread in hot water or 
milk, and mashing it quite soft and even. With 
flaxseed or corn-meal the way is to have a vessel con- 
taining hot water and to pour into it flaxseed meal or 
corn-meal, constantly stirring, until the mixture is as 
thick as porridge, almost (but not quite) soft enough 
to run. Poultices should be spread about half an 
inch thick. To spread a poultice, a piece of fine 
old muslin (or a piece of open-meshed stuff, such as 
ordinary cheese-cloth), twice as long as the poultice 
is to be, is laid on a flat surface, and one-half of it 



SUPPLIES FOR EMERGENCIES. 145 

spread smooth with the poultice material. The other 
half is to be brought over and pressed down on top of 
the poultice material ; or another piece of muslin, or a 
piece of tarlatan can be used for this purpose, so that 
the poultice material shall not come into immediate 
contact with the skin ; then, when it comes to Vpe re- 
moved, it will come off easily, all at one time, and 
not leave any behind to stick to the skin. 

A poultice must be put on hot. To secure this, it 
may be spread upon a hot plate. A simpler plan, 
however, is to take the finished poultice up by its 
edges and lay it for a moment or two on something 
hot, or to dip it into a vessel containing boiling 
water. Care must, however, be taken not to put on 
a poultice so hot as to burn. 

To keep a poultice warm when applied, it should 
be covered with oiled silk or a folded towel. 



146 ACCIDENTS AND EMERGENCIES. 



Signs of Death. 



In the absence of a physician it sometimes be- 
comes important that others shall be able to deter- 
mine whether death has taken place or not. The 
occurrence of death can be recognized by the follow- 
ing signs : The breathing and pulse cease, the surface 
becomes pale, the muscles relax, the lower jaw falls a 
little, the "sight" of the eye becomes dull and 
glazed, the upper lid falls so as to partly cover 
the eyeball, then the whole body gradually cools to 
the temperature of the surrounding air and becomes 
rigid, while later decomposition sets in, and usually 
shows itself first by a greenish discoloration of the 
surface of the abdomen. 

But it does not require the detection of all these 
signs to determine that death has taken place. The 
cessation of breathing and of the heart-beat is a safe 
basis for an opinion. It requires some care, however, 
to decide that there is no breathing or circulation. 
To test the former, a cold piece of polished steel — 
like a razor blade or table-knife — can be held under 
the nose and before the mouth. If no moisture 
condenses upon it, it is safe to say there is no breath- 
ing. To test the cessation of the heart-beat, it is 



SIGNS OF DEATH. 147 

not enough to feel for the pulse at the wrist. The 
largest blood vessel in the body (see Frontispiece) 
runs directly down from the heart, along the left side 
of the spinal column, and its strong beating can be 
plainly felt in most people by pressing the finger tips 
firmly down toward the backbone, at the point below 
the breast bone called the " pit of the stomach." 
In this place the slightest pulsation of the heart can 
be felt if the walls of the abdomen are slack enough 
to permit the finger to get near the backbone ; and 
here examination should be made before deciding 
that the heart has ceased to beat. Another test is 
listening over the region of the heart, in front of the 
left side of the chest. An acute ear can always 
detect the movement of the heart by sounds made by 
its valves, which, when perfect, sound like the sylla- 
bles " ub-dup, " "ub-dup," and so on. If on care- 
ful listening the heart sounds cannot be heard, and 
the cold metal fails to show any evidence of breath- 
ing, the individual may certainly be said to be dead. 

When, in addition to these signs, paleness, mus- 
cular relaxation, a glazing eye, increasing coldness, 
and then rigidity come on, it hardly requires the 
notes of decomposition — the infallible sign — to 
prove, beyond any possibility of doubt, that death 
has occurred. 

The electrical battery may be used in doubtful 
cases. Electricity distinguishes with absolute cer- 
tainty between life and death. Within two or three 



148 ACCIDENTS AND EMERGENCIES. 

hours after the stopping of the heart the whole of the 
muscles of the body will have completely lost their 
electric excitability. When stimulated by electricity, 
they no longer contract. If, then, when electricity 
is applied to the muscles of the face, limbs, or trunk, 
after supposed death, there be no contraction, death 
has occurred. No faint, no trance, no stupor, how- 
ever deep, can prevent the manifestation of electric 
muscular contractility. 

But ordinarily it is very easy to decide between 
death and life \ and the fear of being buried alive, 
which torments many people, is altogether without 
good foundation. The stories upon which it rests 
are such as an excited imagination might easily in- 
vent and natural fear propagate, but they do not 
bear critical investigation. In certain European 
cities, for many years, the bodies of hundreds of 
thousands of those supposed to be dead have been 
placed in rooms where ingenious appliances and 
careful watching have been used to detect the slight- 
est evidence of life, and in not a single case has 
a mistake been found to have been made. 

The author has for years investigated cases in 
which it has been reported in the newspapers that 
persons had been buried alive ; and in every case 
in which he could get any information from a trust- 
worthy source the story has been found to be 
absolutely false. 



NDEX. 



PAGE 

ABDOMEN, contusion 61 
wounds 63 

Absorbent cotton 133 

Accidents, railroad and machinery 72 

Acetate of lead 102 

Acid antidotes 109 

carbolic 100 

muriatic 98 

nitric 98 

oxalic 99 

prussic 100 

sulphuric 98 

Acids, burns with 43 

Aconite 105 

Aconitum napellus 116 

uncinatum .....118 

Adhesive plaster..... 63, 136 

^Ethusa no 

Alcohol, poisoning 106 

Alkalies, burns with 43 

poisoning with 100 

Alkaline antidotes 109 

Alum 137 

Ammonia 139 

poisoning with 100 

aromatic 138 

Ankle, sprains 50 

Antidotes, acid 109 

alkaline 109 

Aorta. 14, 78, 79 

Apoplexy 27, 29 

treatment 37 

Arm, crushed 75 

fractures of 54 

hemorrhage from 84, 86 

wounds 84 

Aromatic spirits of ammonia 138 

Arrow wounds 65 

Arsenic 101 



PAGE 

Arteries, description 78-82 

hemorrhage from 83 

below elbow 85 

of arm 84, 86 

finger 85 

foot.... 87 

forearm... 85 

hand 85 

leg..... .... 87 

neck 84 

scalp 88 

thigh 88 

Artificial respiration 13 

Asthma 125 

Atropa belladonna no 

Atropia poisoning... 104 

DANDAGES 133 

•*-' how to apply..i34~i36 

how to fasten 135 

Belladonna, description of no 

poisoning 104 

Bites of cats and dogs 69 

Bitter-sweet no 

Black-drop 103 

Bland liquids 109 

Bleeding. (See Hemorrhage.) 

Body, crushed 75 

large splinters in 67 

Bones, broken. (See Fractures.) 

Bowels, escaping 63 

hemorrhage from 92 

Brain, compression 40 

concussion 40 

disorders 27 

injuries 40 

Broken bones. (See Fractures.) 

Bruises 61 

Burns 4 I_ 4 2 



149 



150 



INDEX. 



PAGE 

Burns, pain in 42 

with acids 43 

alkalies 43 

pitch 44 

sun 44 

pALOMEL, uses of 138 

^ Capillary hemorrhage 82 

Carbolic acid 100 

Carbonic acid 17 

Carotid arteries 78 

Carron oil 42 

Castor oil 138 

Cat bites 69 

Catalepsy 138 

Caustic alkalies, burns with 43 

lunar 103 

Centipede stings 68 

Charcoal fumes 117 

Chest, contusions 61 

crushed 75 

wounds 64 

Chilblain. (See Frost-bite.) 

Chloral 28 

poisoning 104 

Chlorodyne poisoning 103 

Choking 17 

Cholera morbus 119 

Circulation, description 78-82 

disorders 27 

Cleansing wounds 64-89 

Clots, not to be disturbed 84 

Cloves, oil 139 

Cold, effects 47 - 4§ 

Colic ... 120 

Collar-bone, fractures 58 

Compound fractures 59 

Compression of brain 40 

Concussion of brain 40 

Conium 112 

Contused wounds 62 

Contusions 61 

of abdomen 61 

chest 61 

Convulsions, diagnosis 27-30 

in children 36 

treatment 36, 128 

Coroner, duties 112 

Corrosive sublimate 102 

Cotton absorbent 103 

Cough, whooping 124 

Cow-bane 112 

Creasote 100 

Croton oil 102 

dose of laudanum 109 



PAGE 

Croup 123 

Crushed feet, fingers, hands, toes.. 74 

arm, body, chest, legs 75 

Cuts (See Wounds, incised.) 62 

P^EADLY nightshade 105 

*-' Death, signs of. 14, 146 

Decayed meats.. ic6 

vegetables 106 

Depression, treatment 74, 75, 98 

(See Shock.) 75 

Diarrhoea 121 

Digitalis in 

Dislocations 51-53 

offinger 51 

jaw 51 

shoulder 52 

Disorders of brain 27 

circulation 27 

Dog-bites 69, 70 

not to be cauterized 69 

Domestic emergencies 119 

Drowning 12 

Drunkenness. (See Intoxication.) 

Dwarf-yew .. 111 

Dysentery 122 

CAR, cut off 63 

*-* foreign bodies in 24 

insects in 25 

syringing 24 

Earache 126 

Emergencies, domestic 119 

supplies for 130-144 

Emergency case 130 

use of 133 

Epilepsy, diagnosis .27-29, 35 

treatment 35 

Epileptic fits. (See Epilepsy.) 

Eye, foreign bodies in 21 

lime in 21 

pupils 29 

splinters in 67 

Eyelid, everting 21 

PAINTING 27 

* stops hemorrhage 84, 89 

treatment 33 

Fever 128 

Finger, crushed 74 

cutoff 63 

dislocation 51 

fracture 55 

hemorrhage from 85 

torn off 74 



INDEX. 



151 






PAGE 

Finger wounds 85 

Fish-hook wounds 66 

Fits 33-39 

epileptic 27, 35 

Fool's parsley no 

Foot, crushed 74 

hemorrhage from 87 

needles, etc. in 65 

torn off 75 

Fore-arm, fractures 55 

hemorrhage from 85 

Foreign bodies in ear 21, 24 

eye 21 

nose 21, 23 

throat 18 

wind-pipe 17, 19 

swallowed 19 

Fowler's solution, poisoning with..ioi 

Foxglove, description in 

Fractures 54~6o 

of arm 54 

collarbone 58 

deep-seated bones 57 

finger 55 

fore-arm 55 

hip-bone 57 

jaw 59 

knee-pan 56 

leg 57 

ribs 58 

shoulder-blade 57 

skull 59 

spinal column 59 

thighbone 57 

compound 59 

near joint 57 

swelling after 60 

Freezing 47 

Frost-bite .- 47 

Frozen parts, treatment 47 

GAS, carbonic acid 17 

illuminating 17 

Gases, noxious 17 

poisoning with, detection... 28 

Glass, splinter 67 

Ground hemlock in 

Gullet (choking) 18 

Gunshot wounds 71 

l_J AND, crushed 74 

*■ *■ fish-hookin 66 

hemorrhage from 85 

needles, etc. in 65 

torn off 75 



PAGE 

Hanging 16 

Hartshorn 139 

poisoning with 100 

Head. (See Brain and Scalp.) 

Heat, effects 41-46 

exhaustion 45 

how to apply 76 

stroke 44 

Hellebore, description 117 

Hemlock, poisoning with 105 

ground 111 

poison 112 

water 112 

Hemorrhage 78-92 

after accidents 73 

capillary 8* 

from arm 84-86 

arteries 83 

boweis 92 

fingers 85 

foot 87 

forearm 85 

hand 85 

jugular vein 83 

leg 87 

lungs 91 

neck 84 

nose 91 

scalp 88 

stomach 92 

thigh 88 

tooth-socket 91 

veins 82 

internal 92 

special 91-92 

stopped by fainting... 84 
treatment, recapitu- 
lation 89 

Henbane 113 

Hydrophobia 69 

Hyoscyamus 113 

Hysterics, diagnosis 30 

treatment , 34 

ILLUMINATING gas, poison- 

* ing 17 

Incised wounds 62 

Indian poke 117 

tobacco 105, 114 

turnip 115 

Injured, transportation. 93-96 

Insects, in ear 25 

stings 68 

Insensibility 26-32 

Internal hemorrhage 92 



152 



INDEX. 



PAGE 

Intoxication . 28 

caution in 31 

diagnosis 29 

treatment 38 

Iodine 103 

Ipecac. 139 

Ivy, ppison, description 116 

treatment 127 

TACK-IN-THE-PULPIT 115 

^ Jamestown weed 115 

poisoning with. .105 

Jaw, dislocation 51 

fracture 59 

Jimson weed. (See Jamestown Weed.) 

Joints, dislocation 51 

fracture near 59 

JZIDNEYS, disease of 28 

1*- Knee-pan, fractures 56 

T ACERATED wounds 64-73 

*-" Lacerations 64-73 

Laudanum, dose 109 

poisoning 103 

uses 23, 140 

Lead, sugar of 102 

Leg, crushed 75 

fracture 57 

hemorrhage from 87 

Lightning-stroke 46 

Lime, in eye 23 

Lime-water 141 

how to make 42, 98 

Liquids, bland 109 

Litters 93 

Lobelia 114 

Lung, escape 64 

hemorrhage from 91 

Luxation. (See Dislocation.) 

Lye, poisoning 100 

MACHINERY accidents 72 
Mad-dog bites 70 

Meats, decayed 106 

Mercury bichloride 102 

Monkshood 116 

poisoning 105 

Morphine, poisoning... 103 

Muriatic acid 98 

Mustard 141 

plasters 141 

NAIL, splinters under 66 
Nails, wounds with 65 



PAGE 

Nausea 120 

Neck, wounds 84 

Needles, wounds with 65 

Nervous attacks 125 

Neuralgia 127 

Nightshade, deadly no 

woody no 

poisoning 105 

Nitrate of silver, poisoning 103 

Nitre, sweet spirits 142 

Nitric acid 98 

Nose, bleeding from 91 

cut off. 63 

foreign bodies in 21, 23 

Noxious gases and vapors 17 

OAK, poison. (See Ivy, poison.) 
Obstructions to respiration... 12 

Oil, carron 42 

castor 138 

cloves 139 

croton 102, 109 

vitriol 98 

Opium poisoning 28 

treatment of 103 

DARALYSIS 30 

*■ Paregoric 142 

poisoning 103 

Paris green, poisoning 101 

Parsley, fool's no 

Parsnip, wild 118 

Pepper, red 142 

Phosphorus poisoning 102 

Phytolacca 116 

Pin wounds 65 

Pitch, burns with 44 

Plants, poisonous 110-118 

Plaster, adhesive 63, 136 

mustard 141 

Poison hemlock 112 

ivy (oak, vine) 116, 127 

sumac 105, 116 

Poisoned wounds 68 

Poisoning, recapitulation of treat- 
ment 106, 107 

unconsciousness due to 28 

Poisons 97-118 

acid 98-100 

alkaline 100 

recapitulation of treat- 
ment 106 

unknown 97 

Poisonous plants 110-118 

Poke-berry 116 



INDEX. 



153 



PAGE 

Poke-root 117 

Potash, poisoning 100 

Poultices, how to make 144 

Prussic acid, poisoning 100 

Punctured wounds 65 

RAILROAD accidents 72 
Respiration, artificial 13 

obstructions to... 12 

Rhubarb 143 

Rhus toxicodendron 116 

venenata 116 

Ribs, fracture 58 

CCALDS 4i-43 

^ pain in 42 

Scalp wounds 88 

hair to close 63 

Scorpion stings 68 

Seizures 33 

Serpent bites 68 

Sewing up wounds 63 

Shock 75 

Shoulder, dislocation 52 

Signs of death 14, 146 

Silver, nitrate of. 103 

Skull, fracture 59 

Snakebites 68 

Soda 143 

poisoning with 100 

Spanish windlass 87 

Spider stings 68 

Spinal column, fracture 59 

Splinters 66 

in body 67 

eye 67 

of glass 67 

under nail 66 

Splints 60 

Spotted cow-bane 112 

Sprains < 49 

of ankle 50 

wrist 49 

Sticking plaster 63 

Stimulation 15, 76 

Stimulants 109 

Stings 68 

Stitching wounds 63 

Stomach, hemorrhage from 92 

Stramonium 115 

Strangulation 16 

Stretchers 93 

Strychnine 104 

Stupes.. 143 

Sublimate, corrosive 102 

K 



PAGE 

Suffocation 17 

Sugar of lead 102 

Sulphuric acid 98 

Sumac 105, 116 

Sunburn 44 

Sunstroke 39, 44 

Supplies for emergencies 130-144 

Syrup of rhubarb 143 

TACK wounds 65 
Tarantula stings 68 

Tartar emetic 102 

Tears 73 

Temperature of skin 30 

Thigh, hemorrhage from 88 

wounds 88 

Thigh-bone, fractures 56 

Thorn-apple 115 

Thorns, wounds with 66 

Throat, wounds 64 

Toadstools 105 

Tobacco 105 

Indian 105, 114 

Toes, crushed 74 

cutoff 63 

torn off 74 

Tooth, bleeding after extraction... 91 

Toothache 126 

Transportation of injured 93~96 

Turnip, Indian 115 

Turpentine 143 

stupe 143 

UNCONSCIOUSNESS ... 26-32 
causes 27 

examination in... 29 
treatment 21 

VAPORS, noxious 17 
Varicose veins 82 

Vegetables, decayed 106 

Veins 80 

hemorrhage from 82 

varicose 82 

Veratrum poisoning 105 

album 117 

viride 117 

Virginia creeper 116 

Vitriol, oil of. 98 

Vomiting 120 

how to provoke 108 

WATER hemlock 112 
Weed, Jamestown (Jimson).ii5 
Whisky, dose 144 



154 



INDEX. 



PAGE 

Whooping-cough 124 

Wild parsnip 118 

Windlass, Spanish 87 

Windpipe, foreign bodies in 17 

Wolf's-bane 118 

Woody nightshade no 

Wounds 61-71 

cleansing of. 64 

stitching of 63 

contused 62 

gunshot 71 

incised 62 

lacerated 64-73 

poisoned 68 

punctured 65 

of abdomen 63 

arm 84, 86 

chest 64 

fingers 85 



PAGE 

Wounds of foot 87 

forearm 85 

hand 85 

leg 87 

neck 84 

scalp 88 

thigh 88 

throat 64 

with arrow 65 

glass 67 

nail 65 

needle 65 

tack 65 

Pin 65 

thorn 66 

Wrist, sprains of 49 

VEW, dwarf m 



CATALOGUE No. 7. 



SEPTEMBER, 1892. 



A CATALOGUE 

OF 

Books for Students. 

INCLUDING THE 

? QUIZ-COMPENDS ? 



CONTENTS. 



PAGE 

New Series of Manuals, 2,3,4,5 

Anatomy, 

Biology, 

Chemistry, . 

Children's Diseases, 

Dentistry, 

Dictionaries, 

Eye Diseases, 

Electricity, . 

Gynaecology, 

Hygiene, 

Materia Medica 

Medical Jurisprudence, 

Nervous Diseases, 



PAGE 

Obstetrics 10 

Pathology, Histology, . . 11 
Pharmacy, . . . .12 
Physical Diagnosis, . . n 
Physiology, . . . .11 
Practice of Medicine, . 11, 12 
Prescription Books, . . 12 
?Quiz-Compends ? . 
Skin Diseases, 
Surgery and Bandaging, 
Therapeutics, 
Urine and Urinary Organs, 
Venereal Diseases, 



14, 15 



PUBLISHED BY 



P. BLAKISTON, SON & CO., 

Medical Booksellers, Importers and Publishers. 

LARGE STOCK OF ALL STUDENTS' BOOKS, AT 
THE LOWEST PRICES. 

1012 Walnut Street, Philadelphia. 



*** For sale by all Booksellers, or any book will be sent by mail, 
postpaid, upon receipt of price. Catalogues of books on all branches 
of Medicine, Dentistry, Pharmacy, etc., supplied upon application. 

p/i£?xo C ceifts } 3 °°° Q uestions on Medical Subjects. 



" An excellent Series of Manuals." — Archives of Gynecology. 

A NEW SERIES OF 

STUDENTS' MANUALS 

On the various Branches of Medicine and Surgery. 

Can be used by Students of any College. 

Price of each, Handsome Cloth, $3.00. Full Leather, $3.50 

The object of this series is to furnish good manuals 
for the medical student, that will strike the medium 
between the compend on one hand and the prolix text- 
book on the other — to contain all that is necessary for 
the student, without embarrassing him with a flood of 
theory and involved statements. They have been pre- 
pared by well-known men, who have had large experience 
as teachers and writers, and who are, therefore, well 
informed as to the needs of the student. 

Their mechanical execution is of the best — good type 
and paper, handsomely illustrated whenever illustrations 
are of use, and strongly bound in uniform style. 

Each book is sold separately at a remarkably low 
price, and the immediate success of several of the 
volumes shows that the series has met with popular 
favor. 

No. 1. SURGERY. 318 Illustrations. 

Third Edition. 

A Manual of the Practice of Surgery. By Wm. J. 

Walsham, m.d., Asst. Surg, to, and Demonstrator of 

Surg, in, St. Bartholomew's Hospital, London, etc. 

318 Illustrations. 

Presents the introductory facts in Surgery in clear, precise 
language, and contains all the latest advances in Pathology, 
Antiseptics, etc. 

" It aims to occupy a position midway between the pretentious 
manual and the cumbersome System of Surgery, and its general 
character may be summed up in one word — practical." — The Medi- 
cal Bulletin. 

"Walsham, besides being an excellent surgeon, is a teacher in 
its best sense, and having had very great experience in the 
preparation of candidates for examination, and their subsequent 
professional career, may be relied upon to have carried out his 
work successfully. Without following out in detail his arrange- 
ment, which is excellent, we can at once say that his book is an 
embodiment of modern ideas neatly strung together, with an amount 
of careful organization well suited to the candidate, and, indeed, to 
the practitioner." — British Medical Journal. 

Price of each Book, Cloth, $3.00; Leather, $3.50. 



THE NEW SERIES OF MANUALS. 



No. 2. DISEASES OF "WOMEN. 150 Illus. 

NEW EDITION. 

The Diseases of Women. Including Diseases of the 
Bladder and Urethra. By Dr. F. Winckel, Professor 
of Gynaecology and Director of the Royal University 
Clinic for Women, in Munich. Second Edition. Re- 
vised and Edited by Theophilus Parvin, m.d., 
Professor of Obstetrics and Diseases of Women and 
Children in Jefferson Medical College. 150 Engrav- 
ings, most of which are original. 
" The book will be a valuable one to physicians, and a safe and 

satisfactory one to put into the hands of students. It is issued in a 

neat and attractive form, and at a very reasonable price." — Boston 

Medical and Surgical Journal . 

No. 3. OBSTETRICS. 227 Illustrations. 
A Manual of Midwifery. By Alfred Lewis Galabin, 
M.A., M.D., Obstetric Physician and Lecturer on Mid- 
wifery and the Diseases of Women at Guy's Hospital, 
London; Examiner in Midwifery to the Conjoint 
Examining Board of England, etc. With 227 Illus. 
"This manual is one we can strongly recommend to all who 
desire to study the science as well as the practice of midwifery. 
Students at the present time not only are expected to know the 
principles of diagnosis, and the treatment of the various emergen- 
cies and complications that occur in the practice of midwifery, but 
find that the tendency is for examiners to ask more questions 
relating to the science of the subject than was the custom a few 
years ago. * * * The general standard of the manual is high ; 
and wherever the science and practice of midwifery are well taught 
it will be regarded as one of the most important text-books on the 
subject." — London Practitioner . 

No. 4. PHYSIOLOGY. Fifth Edition. 

321 ILLUSTRATIONS AND A GLOSSARY. 
A Manual of Physiology. By Gerald F. Yeo, m.d., 

f.r.cs., Professor of Physiology in King's College, 

London. 321 Illustrations and a Glossary of Terms. 

Fifth American from last English Edition, revised and 

improved. 758 pages. 

This volume was specially prepared to furnish students with a 
new text-book of Physiology, elementary so far as to avoid theories 
which have not borne the test of time and such details of methods 
as are unnecessary for students in our medical colleges. 

"The brief examination I have given it was so favorable that I 
placed it in the list of text-books recommended in the circular of the 
University Medical College." — Prof. Lewis A. Stimson, m.d., 
57 East 33d Street, Neiv York. 

Price of each Book, Cioth, $3.00; Leather, $3.50. 



THE NEW SERIES OF MANUALS. 



No. 5. DISEASES OP CHILDREN. 

SECOND EDITION. 
A Manual. By J. F. Goodhart, m.d., Phys. to the 
Evelina Hospital for Children ; Asst. Phys. to 
Guy's Hospital, London. Second American Edition. 
Edited and Rearranged by Louis Starr, m.d., Clinical 
Prof, of Dis. of Children in the Hospital of the Univ. 
of Pennsylvania, and Physician to the Children's Hos- 
pital, Phila. Containing many new Prescriptions, a list 
of over 50 Formulae, conforming to the U. S. Pharma- 
copoeia, and Directions for making Artificial Human 
Milk, for the Artificial Digestion of Milk, etc. Illus. 

" The author has avoided the not uncommon error of writing a 
book on general medicine and labeling it * Diseases of Children/ 
but has steadily kept in view the diseases which seemed to be 
incidental to childhood, or such points in disease as appear to be so 
peculiar to or pronounced in children as to justify insistence upon 
them. * * * A safe and reliable guide, and in many ways 
admirably adapted to the wants of the student and practitioner." — 
American Journal of Medical Science. 

No. 6. MATERIA MEDICA, PHARMACY, 
PHARMACOLOGY, AND THE- 
RAPEUTICS. 

JUST READY. 
A Handbook for Students. By Wm. Hale White, 
M.D., F.R.G.P., etc., Physician to, and Lecturer on Ma- 
teria Medica, Guy's Hospital; Examiner in Materia 
Medica, Royal College of Physicians, London, etc. 
American Edition. Revised by Reynold W. Wilcox, 
m.a., m.d., Prof, of Clinical Medicine at the New York 
Post-Graduate Medical School and Hospital ; Assistant 
Visiting Physician Bellevue Hospital. 580 pages. 
In preparing this book, the wants of the medical student of to-day 
have been constantly kept in view. The division into several sub- 
jects, which are all arranged in a systematic, practical manner, will 
be found of great help in mastering the whole. The work of the 
editor has been mainly in the line of adapting the book to the use 
of American students ; at the same time, however, he has added 
much new material. Dr. Wilcox's long experience in teaching 
and writing on therapeutical subjects particularly fits him for the 
position of editor, and the double authorship has resulted in mak- 
ing a very complete handbook, containing much minor useful in- 
formation that if prepared by one man might have been overlooked. 

Price of each Book, Cloth, $3.00 ; Leather, $3.50. 



THE NEW SERIES OF MANUALS. 



No. 7. MEDICAL JURISPRUDENCE AND 
TOXICOLOGY. 

THIRD REVISED EDITION. 

By John J. Reese, m.d., Professor of Medical Jurispru- 
dence and Toxicology in the University of Pennsyl- 
vania ; President of the Medical Jurisprudence Society 
of Phila. ; Third Edition, Revised and Enlarged. 

" This admirable text-book." — Amer.Jour. of Med. Sciences. 

u We lay this volume aside, after a careful perusal of its pages, 
with the profound impression that it should be in the hands of every 

doctor and lawyer. It fully meets the wants of all students 

He has succeeded in admirably condensing into a handy volume all 
the essential points." — Cincinnati Lancet and Clinic, 

" The book before us will, we think, be found to answer the ex- 
pectations of the student or practitioner seeking a manual of juris- 
prudence, and the call for a second edition is a flattering testimony 
to the value of the author's present effort. The medical portion 
of this volume seems to be uniformly excellent, leaving little for 
adverse criticism. The information on the subject matter treated 
has been carefully compiled, in accordance with recent knowledge. 
The toxicological portion appears specially excellent. Of that por- 
tion of the work treating of the legal relations of the practitioner 
and medical witness, we can express a generally favorable ver- 
dict." — Physician and Surgeon, Ann Arbor y Mich. 

No. 8. DISEASES OF THE EYE. 176 Illus. 

FOURTH EDITION. JUST READY. 

Diseases of the Eye and their Treatment. A Handbook 
for Physicians and Students. By Henry R. Swanzy, 
a.m., m.b., f.r.c.s.i., Surgeon to the National Eye and 
Ear Infirmary ; Ophthalmic Surgeon to the Adelaide 
Hospital, Dublin; Examiner in Ophthalmic Surgery 
in the Royal University of Ireland. Fourth Edition, 
Thoroughly Revised. 176 Illustrations and a Zephyr 
Test Plate. 500 pages. 

" Mr. Swanzy has succeeded in producing the most intellectually 
conceived and thoroughly executed resume of the science within 
the limits he has assigned himself. As a ' students' handbook/ 
small in size and moderate in price, it can hardly be equaled." — 
Medical News. 

" A full, clear, and comprehensive statement of Eye Diseases 
and their treatment, practical and thorough, and we feel fully jus- 
tified in commending it to our readers. It is written in a clear and 
forcible style, presenting in a condensed yet comprehensive form 
current and modern information that will prove alike beneficial to 
the student and general practitioner." — Southern Practitioner, 

Price of each Book, Cloth, $3.00 ; Leather, $3.50. 



6 STUDENTS' TEXT-BOOKS AND MANUALS. 

ANATOMY. 

Morris' New Text-Book on Anatomy. 600 Specially En- 
graved Illustrations, many of which are printed in colors. Edi- 
ted by Henry Morris, f.r c.s., and contributed to by many well- 
known writers. Octavo. Nearly Ready. Price about 6.00 
*#* Send for Descriptive Circular and Sample Pages. 

Macalister's Human Anatomy. 816 Illustrations. A new 
Text-book for Students and Practitioners, Systematic and Topo- 
graphical, including the Embryology, Histology, and Morphology 
of Man. With special reference to the requirements of 
Practical Surgery and Medicine. With 816 Illustrations, 
400 of which are original. Octavo. Cloth, 7.50; Leather, 8.50 

Ballou's Veterinary Anatomy and Physiology. Illustrated. 
By Wm. R. Ballou, m.d., Professor of Equine Anatomy at New 
York College of Veterinary Surgeons. 29 graphic Illustrations. 
i2mo. Cloth, 1. 00; Interleaved for notes, 1. «5 

Holden's Anatomy. A manual of Dissection of the Human 
Body. Fifth Edition. Enlarged, with Marginal References and 
over 200 Illustrations. Octavo. 

Bound in Oilcloth, for the Dissecting Room, $4.50. 

Holden's Human Osteology. Comprising a Description of the 
Bones, with Colored Delineations of the Attachments of the 
Muscles. The General and Microscopical Structure of Bone and 
its Development. With Lithographic Plates and Numerous Illus- 
trations. Seventh Edition. 8vo. Cloth, 6.00 

Holden's Landmarks, Medical and Surgical. 4th ed. Clo., 1.25 

Potter's Compend of Anatomy. Fifth Edition. Enlarged. 
16 Lithographic Plates. 117 Illustrations. See Page 14. 

Cloth, 1. 00; Interleaved for Notes, 1.25 

CHEMISTRY. 

Bartley's Medical Chemistry. Second Edition. A text-book 
prepared specially for Medical, Pharmaceutical, and Dental Stu- 
dents. With 50 Illustrations, Plate of Absorption Spectra and 
Glossary of Chemical Terms. Revised and Enlarged. Cloth, 2 . 50 

Trimble. Practical and Analytical Chemistry. A Course in 
Chemical Analysis, by Henry Trimble, Prof, of Analytical Chem- 
istry in the Phila. College of Pharmacy. Illustrated. Fourth 
Edition, Enlarged. 8vo. Cloth, 1.50 

Bloxam's Chemistry, Inorganic and Organic, with Experiments. 
Seventh Edition. 281 Illustrations. Cloth, 4.50; Leather, 5.50 
J^* See pages 2 to 5 for list 0/ Students' Manuals . 



STUDENTS' TEXT-BOOKS AND MANUALS. 7 

Chemistry : — Continued. 

Richter's Inorganic Chemistry. Third American, from Fifth 
German Edition. Translated by Prof. Edgar F. Smith, ph.d. 
89 Wood Engravings and Colored Plate of Spectra. Cloth, 2.00 

Richter's Organic Chemistry, or Chemistry of the Carbon 
Compounds. Illustrated. Second Edition. Cloth, 4.50 

Symonds. Manual of Chemistry, for the special use of Medi- 
cal Students. By Brandreth Symonds, a.m., m.d., Asst. 
Physician Roosevelt Hospital, Out- Patient Department ; Attend- 
ing Physician Northwestern Dispensary, New York. Cloth, 2.00 

Leffmann's Compend of Chemistry. Inorganic and Organic. 
Including Urinary Analysis. Third Edition. Revised. 
See page ij. Cloth, 1. 00; Interleaved for Notes, 1.25 

Leffmann and Beam. Progressive Exercises in Practical 
Chemistry. i2mo. Illustrated. Cloth, 1.00 

Muter. Practical and Analytical Chemistry. Fourth Edi- 
tion. Revised, to meet the requirements of American Medical 
Colleges, by Prof. C. C. Hamilton. Illustrated. Cloth, 2.00 

Holland. The Urine, Common Poisons, and Milk Analysis, 
Chemical and Microscopical. For Laboratory Use. Fourth 
Edition, Enlarged. Illustrated. Cloth, 1.00 

Van Niiys. Urine Analysis. Illus. Cloth, 2.00 

CHILDREN. 

Goodhart and Starr. The Diseases of Children. Second 
Edition. By J. F. Goodhart, m.d., Physician to the Evelina 
Hospital for Children ; Assistant Physician to Guy's Hospital, 
London. Revised and Edited by Louis Starr, m.d., Clinical 
Professor of Diseases of Children in the Hospital of the Univer- 
sity of Pennsylvania; Physician to the Children's Hospital, 
Philadelphia. Containing many Prescriptions and Formulae, 
conforming to the U. S. Pharmacopoeia, Directions for making 
Artificial Human Milk, for the Artificial Digestion of Milk, etc. 
Illustrated. Cloth, 3.00; Leather, 3.50 

Hatfield. Diseases of Children. By M. P. Hatfield, m.d., 
Professor of Diseases of Children, Chicago Medical College. 
Colored Plate. i2mo. Cloth, 1.00; Interleaved, 1.25 

Starr. Diseases of the Digestive Organs in Infancy and 
Childhood. With chapters on the Investigation of Disease, 
and on the General Management of Children. By Louis Starr, 
m.d., Clinical Professor of Diseases of Children in the Univer- 
sity of Pennsylvania. Illus. Second Edition. Cloth, 2.25 
4$~ See pages 14 and IS for list of ? Quiz- Comp ends? 



8 STUDENTS' TEXT-BOOKS AND MANUALS. 

DENTISTRY. 

Fillebrown. Operative Dentistry. 330 Illus. Cloth, 2.50 

Flagg's Plastics and Plastic Filling. 4th Ed. Cloth, 4.00 
Gorgas. Dental Medicine. Fourth Edition. Cloth, 3.50 

Harris. Principles and Practice of Dentistry. Including 
Anatomy, Physiology, Pathology, Therapeutics, Dental Surgery 
and Mechanism. Twelfth Edition. Revised and enlarged by 
Professor Gorgas. 1028 Illustrations. Cloth, 7.00 ; Leather, 8.00 
Richardson's Mechanical Dentistry. Fifth Edition. 569 
Illustrations. 8vo. Cloth, 4.50; Leather, 5.50 

Sewill. Dental Surgery. 200 Illustrations. 3d Ed. Clo., 3.00 
Taft's Operative Dentistry. Dental Students and Practitioners. 
Fourth Edition. 100 Illustrations. Cloth, 4.25 ; Leather, 5.00 
Talbot. Irregularities of the Teeth, and their Treatment. 
Illustrated. 8vo. Second Edition. Cloth, 3.00 

Tomes' Dental Anatomy. Third Ed. 191 Illus. Cloth, 4.00 
Tomes' Dental Surgery. 3d Edition. 292 Illus. Cloth, 5.00 
Warren. Compend of Dental Pathology and Dental Medi- 
cine. Illustrated. Cloth, 1.00; Interleaved, 1.25 

DICTIONARIES. 

Gould's New Medical Dictionary. Containing the Definition 
and Pronunciation of all words in Medicine, with many useful 
Tables etc. y 2 Dark Leather, 3.25 ; y 2 Mor., Thumb Index, 4.25 

Gould's Pocket Dictionary. 12,000 Medical Words Pro- 
nounced and Defined. Containing many Tables and an 
Elaborate Dose List. Thin 641110. Just Ready. 

Cloth, 1. 00; Leather, 1.25 

Harris' Dictionary of Dentistry. Fifth Edition. Completely 
revised by Prof. Gorgas. Cloth, 5.00; Leather, 6.00 

Cleaveland's Pronouncing Pocket Medical Lexicon. Small 
pocket size. Cloth, red edges .75 ; pocket-book style, 1.00 

Longley's Pocket Dictionary. The Student's Medical Lexicon, 
giving Definition and Pronunciation , with an Appendix giving 
Abbreviations used in Prescriptions, Metric Scale of Doses, etc. 
24mo. Cloth, 1. 00; pocket-book style, 1.25 

EYE. 

Hartridge on Refraction. 5th Edition. Illus. Cloth, 2.00 

Swanzy. Diseases of the Eye and their Treatment. 176 

Illustrations. Fourth Edition. Cloth, 300; Leather, 3.50 

Fox and Gould. Compend of Diseases of the Eye and 

Refraction. 2d Ed. Enlarged. 71 Illus. 39 Formulae. 

Cloth, 1. 00 ; Interleaved for Notes, 1.25 

f^ See pages 2 to 5 for list of Students' Manuals. 



STUDENTS' TEXT-BOOKS AND MANUALS. 9 

ELECTRICITY. 

Bigelow. Plain Talks on Medical Electricity. Cloth, i.oo 

Mason's Compend of Medical Electricity. Cloth, i.oo 

Steavenson and Jones. Medical Electricity. A Practical 

Handbook. Just Ready. Illustrated. i2mo. Cloth, 2.50 

HYGIENE. 

Coplin and Bevan. Practical Hygiene. By W. M. L. Cop- 
lin, Adjunct Professor of Hygiene, Jefferson Medical College, 
Philadelphia, and Dr. D. Bevan. Illustrated. In Press . 

Parkes' (Ed. A.) Practical Hygiene. Seventh Edition, en- 
larged. Illustrated. 8vo. Cloth, 4.50 

Parkes' (L-. C.) Manual of Hygiene and Public Health. 
Second Edition. i2mo. Cloth, 2.50 

Wilson's Handbook of Hygiene and Sanitary Science. 

Seventh Edition. Revised and Illustrated. Cloth, 3.25 

MATERIA MEDICA AND THERAPEUTICS. 

Potter's Compend of Materia Medica, Therapeutics, and 
Prescription Writing. Fifth Edition, revised and improved. 
See page if. Cloth, 1.00; Interleaved for Notes, 1.25 

Davis. Essentials of Materia Medica and Prescription 
Writing. By J. Aubrey Davis, m.d., Demonstrator of Obstet- 
rics and Quiz-Master on Materia Medica, University of Penn- 
sylvania. i2mo. Interleaved. Net, 1.50 

Biddle's Materia Medica. Eleventh Edition. By the late 
John B. Biddle, m.d. Revised by Clement Biddle, m.d., 8vo, 
illustrated. Cloth, 4.25; Leather, 5.00 

Potter. Handbook of Materia Medica, Pharmacy, and 
Therapeutics. Including Action of Medicines, Special Thera- 
peutics, Pharmacology, etc. By Saml. O. L. Potter, m.d., 
m.r.c.p. (Lond.), Professor of the Practice of Medicine in 
Cooper Medical College, San Francisco. Third Revised and 
Enlarged Edition. 8vo. Cloth, 4.00; Leather, 5.00 

White and Wilcox. Materia Medica, Pharmacy, Phar- 
macology, and Therapeutics. A Handbook for Students. 
By Wm. Hale White, m.d., f.r.c.p., etc., Physician to and 
Lecturer on Materia Medica, Guy's Hospital. Revised by 
Reynold W. Wilcox, m.d., Professor of Clinical Medicine at the 
New York Post Graduate Medical School, Assistant Physician 
Bellevue Hospital, etc. American Edition. Clo., 3.00; Lea., 3.50 
4^* See pages 14 and rj for list of f Quiz-Cotnpends ? 



10 STUDENTS' TEXT-BOOKS AND MANUALS. 

MEDICAL JURISPRUDENCE. 

Reese. A Text-book of Medical Jurisprudence and Toxi- 
cology. By John J. Reese, m.d., Professor of Medical Juris- 
prudence and Toxicology in the Medical Department of the 
University of Pennsylvania ; Physician to St. Joseph's Hospital. 
Third Edition. Cloth, 3.00; Leather, 3.50 

NERVOUS DISEASES. 

Gowers. Manual of Diseases of the Nervous System. 
A Complete Text-book. By William R. Gowers, m.d., Prof. 
Clinical Medicine, University College, London. Physician to 
National Hospital for the Paralyzed and Epileptic. Second 
Edition. Revised, Enlarged, and in many parts Rewritten. 
With many new Illustrations, Octavo. 

Vol. I. Diseases of the Nerves and Spinal Cord. 616 

pages. Cloth, 3.50 

Vol. II. Diseases of the Brain and Cranial Nerves. 
General and Functional Diseases. Nearly Ready. 

Ormerod. Diseases of Nervous System. Student's Guide to. 
By J. A. Ormerod, m.d., Oxon., f.r.c.p. (London), Member Path- 
ological, Clinical, Ophthalmological, and Neurological Societies, 
Physician to National Hospital for Paralyzed and Epileptic and 
to City of London Hospital for Diseases of the Chest, Demon- 
strator of Morbid Anatomy, St. Bartholomew's Hospital, etc. 
With 75 Wood Engravings. Cloth, 2.00 

OBSTETRICS AND GYNAECOLOGY. 

Davis. A Manual of Obstetrics. By Edw. P. Davis, Dem- 
onstrator of Obstetrics, Jefferson Medical College, Philadelphia. 
Colored Plates, and 130 other Illustrations. i2mo. Cloth, 2.00 

Byford. Diseases of Women. The Practice of Medicine and 
Surgery, as applied to the Diseases and Accidents Incident to 
Women. By W. H. Byford, a.m., m.d., Professor of Gynaecology 
in Rush Medical College and of Obstetrics in the Woman's Med- 
ical College, etc., and Henry T. Byford, m.d., Surgeon to the 
Woman's Hospital of Chicago. Fourth Edition. Revised and 
Enlarged. 306 Illustrations, over 100 of which are original. 
Octavo. 832 pages. Cloth, 5.00 ; Leather, 6.00 

Lewers' Diseases of Women. A Practical Text-book. 139 
Illustrations. Second Edition. Cloth, 2.50 

Parvin's Winckel's Diseases of Women. Second Edition. 
Including a Section on Diseases of the Bladder and Urethra. 
150 Illus. Revised. See page 3. Cloth, 3.00; Leather, 3.50 

Morris. Compend of Gynaecology. Illustrated. Cloth, 1.00 

WinckePs Obstetrics. A Text-book on Midwifery, includ- 
ing the Diseases of Childbed. By Dr. F. Winckel, Professor 
of Gynaecology, and Director of the Royal University Clinic for 
Women, in Munich. Authorized Translation, by J. Clifton 
Edgar, m.d., Lecturer on Obstetrics, University Medical Col- 
lege, New York, with nearly 200 handsome Illustrations, the 
majority of which are original. 8vo. Cloth, 6.00; Leather, 7.00 

4^~ See pages 2 to 5 for list of New Manuals. 



STUDENTS' TEXT-BOOKS AND MANUALS. 11 

Obstetrics and Gynecology : — Continued. 
Landis' Compend of Obstetrics. Illustrated. 4th Edition, 
Enlarged. Cloth, 1.00; Interleaved for Notes, 1.25 

Galabin's Midwifery. By A. Lewis Galabin, m.d., f.r.c.p. 
227 Illustrations. Seepages. Cloth, 3.00; Leather, 3.50 

PATHOLOGY, HISTOLOGY, ETC. 

Wethered. Medical Microscopy. By Frank J. Wethered, 
m.d., m.r.c.p. 98 Illustrations. Cloth, 2.50 

Bowlby. Surgical Pathology and Morbid Anatomy, for 
Students. 135 Illustrations. i2mo. Cloth, 2.00 

Gilliam's Essentials of Pathology. A Handbook for Students. 
47 Illustrations. i2mo. Cloth, 2.00 

Virchow's Post-Mortem Examinations. 3d Ed. Cloth, 1.00 

PHYSICAL DIAGNOSIS. 

Fenwick. Student's Guide to Physical Diagnosis. 7th 
Edition. 117 Illustrations. i2mo. Cloth, 2.25 

Tyson's Student's Handbook of Physical Diagnosis. Illus- 
trated. i2mo. Cloth, 1.25 

PHYSIOLOGY. 

Yeo's Physiology. Fifth Edition. The most Popular Stu- 
dents' Book. By Gerald F. Yeo, m.d., f.r.c.s., Professor of 
Physiology in King's College, London. Small Octavo. 758 
pages. 321 carefully printed Illustrations. With a Full 
Glossary and Index. See page 3. Cloth, 3.00; Leather, 3.50 

Brubaker's Compend of Physiology. Illustrated. Sixth 
Edition. Cloth, 1. 00; Interleaved for Notes, 1.25 

Kirke's Physiology. New 13th Ed. Thoroughly Revised and 
Enlarged. 502 Illustrations, some of which are printed in colors. 

Cloth, 4.00 ; Leather, 5.00 

Landois' Human Physiology. Including Histology and Micro- 
scopical Anatomy, and with special reference to Practical Medi- 
cine. Fourth Edition. Translated and Edited by Prof. Stirling. 
845 Illustrations. Cloth, 7.00 ; Leather, 8.00 

M With this Text-book at his command, no student could fail in 

his examination." — Lancet. 

Sanderson's Physiological Laboratory. Being Practical Ex- 
ercises for the Student. 350 Illustrations. 8vo. Cloth, 5.00 

PRACTICE. 

Taylor. Practice of Medicine. A Manual. By Frederick 
Taylor, m.d., Physician to, and Lecturer on Medicine at, Guy's 
Hospital, London ; Physician to Evelina Hospital for Sick Chil- 
dren, and Examiner in Materia Medica and Pharmaceutical 
Chemistry, University of London. Cloth, 2.00; Leather, 2.50 

J9&~ See pages 14 and 15 for list of ? Quiz- Comp ends t 



12 STUDENTS' TEXT-BOOKS AND MANUALS. 

Practice : — Continued. 

Roberts' Practice. New .Revised Edition. A Handbook 
of the Theory and Practice of Medicine. By Frederick T. 
Roberts, m.d., m.r.c.p., Professor of Clinical Medicine and 
Therapeutics in University College Hospital, London. Seventh 
Edition. Octavo. Cloth, 5.50 ; Sheep, 6.50 

Hughes. Compend of the Practice of Medicine. 4th Edi- 
tion. Two parts, each, Cloth, 1.00; Interleaved for Notes, 1.25 
Part i. — Continued, Eruptive and Periodical Fevers, Diseases 

of the Stomach, Intestines, Peritoneum, Biliary Passages, Liver, 

Kidneys, etc., and General Diseases, etc. 

Part ii. — Diseases of the Respiratory System, Circulatory 

System, and Nervous System; Diseases of the Blood, etc. 
Physicians' Edition. Fourth Edition. Including a Section 
on Skin Diseases. With Index. 1 vol. Full Morocco, Gilt, 2.50 

From. John A. Robinson, M.D., Assistant to Chair of Clinical 
Medicine, now Lecturer on Materia Medica, Rush Medical Col- 
lege, Chicago. 
"Meets with my hearty approbation as a substitute for the 

ordinary note books almost universally used by medical students. 

It is concise, accurate, well arranged, and lucid, . . . just the 

thing for students to use while studying physical diagnosis and the 

more practical departments of medicine." 

PRESCRIPTION BOOKS. 

Wythe's Dose and Symptom Book. Containing the Doses 
and Uses of all the principal Articles of the Materia Medica, etc. 
Seventeenth Edition. Completely Revised and Rewritten. Just 
Ready. 321110. Cloth, 1. 00; Pocket-book style, 1.25 

Pereira's Physician's Prescription Book. Containing Lists 
of Terms, Phrases, Contractions, and Abbreviations used in 
Prescriptions, Explanatory Notes, Grammatical Construction of 
Prescriptions, etc., etc. By Professor Jonathan Pereira, m.d. 
Sixteenth Edition. 321110. Cloth, 1. 00; Pocket-book style, 1.25 

PHARMACY. 

Stewart's Compend of Pharmacy. Based upon Remington's 
Text-book of Pharmacy. Third Edition, Revised. With new 
Tables, Index, Etc. Cloth, 1.00 ; Interleaved for Notes, 1.25 

Robinson. Latin Grammar of Pharmacy and Medicine. 
By H. D. Robinson, ph.d., Professor of Latin Language and 
Literature, University of Kansas, Lawrence. With an Intro- 
duction by L. E. Sayre, ph.g., Professor of Pharmacy in, and 
Dean of, the Dept. of Pharmacy, University of Kansas. i2mo. 

Cloth, 2.00 

SKIN DISEASES. 

Anderson, (McCall) Skin Diseases. A complete Text-book, 
with Colored Plates and numerous Wood Engravings. 8vo. 

Cloth, 4.50; Leather, 5.50 

Van Harlingen on Skin Diseases. A Handbook of the Dis- 
eases of the Skin, their Diagnosis and Treatment (arranged alpha- 
betically). By Arthur Van Harlingen, m.d., Clinical Lecturer 
on Dermatology, Jefferson Medical College; Prof, of Diseases of 
the Skin in the Philadelphia Polyclinic. 2d Edition. Enlarged. 
With colored and other plates and illustrations. i2mo. Cloth, 2.50 
4^* See pages 2 to 5 for list of Neiv Manuals. 



STUDENTS' TEXT-BOOKS AND MANUALS. 13 

SURGERY AND BANDAGING. 

Moullin's Surgery. 500 Illustrations (some colored), 200 of 
which are original. Cloth, net 7.00; Leather, net 8.00 

Jacobson. Operations in Surgery. A Systematic Handbook 
for Physicians, Students, and Hospital Surgeons. By W. H. A. 
Jacobson, b.a. Oxon., f.r.c.s. Eng. ; Ass't Surgeon Guy's Hos- 
pital ; Surgeon at Royal Hospital for Children and Women, etc. 
199 Illustrations. 1006 pages. 8vo. Cloth. 5.00; Leather, 6.00 

Heath's Minor Surgery, and Bandaging. Ninth Edition. 142 
Illustrations. 60 Formulae and Diet Lists. Cloth, 2.00 

Horwitz's Compend of Surgery, Minor Surgery and 
Bandaging, Amputations, Fractures, Dislocations, Surgical 
Diseases, and the Latest Antiseptic Rules, etc., with Differential 
Diagnosis and Treatment. By Orville Hokwitz, b.s., m.d., 
Demonstrator of Surgery, Jefferson Medical College. 4th edition. 
Enlarged and Rearranged. 136 Illustrations and 84 Formulae. 
i2mo. Cloth, 1. 00 ; Interleaved for the addition of Notes, 1.25 
*^.*The new Section on Bandaging and Surgical Dressings con- 
sists of 32 Pages and 41 Illustrations. Every Bandage of any 
importance is figured. This, with the Section on Ligation of 
Arteries, forms an ample Text-book for the Surgical Laboratory. 

Walsham. Manual of Practical Surgery. Third Edition. 
By Wm. J. Walsham, m.d., f.r.c.s., Asst. Surg, to, and Dem- 
of Practical Surg, in, St. Bartholomew's Hospital; Surgeon to 
Metropolitan Free Hospital, London. With 318 Engravings. 
See page 2. Cloth, 3.00; Leather, 3.50 

URINE, URINARY ORGANS, ETC. 

Holland. The Urine, and Common Poisons and The 
Milk. Chemical and Microscopical, for Laboratory Use. Illus- 
trated. Fourth Edition. i2mo. Interleaved. Cloth, 1.00 

Ralfe. Kidney Diseases and Urinary Derangements. 42 Illus- 
trations. i2mo. 572 pages. Cloth, 2.75 

Marshall and Smith. On the Urine. The Chemical Analysis of 
the Urine. By John Marshall, m.d., Chemical Laboratory, Univ. 
of Penna; and Prof. E. F. Smith, ph.d. Col. Plates. Cloth, 1.00 

Memminger. Diagnosis by the Urine. Illustrated. 

Cloth, 1. 00 

Tyson. On the Urine. A Practical Guide to the Examination 
of Urine. With Colored Plates and Wood Engravings. 7th Ed. 
Enlarged. i2mo. Cloth, 1.50 

Van Niiys, Urine Analysis. Illus. Cloth, 2.00 

VENEREAL DISEASES. 

Hill and Cooper. Student's Manual of Venereal Diseases, 
with Formula. Fourth Edition. i2mo. Cloth, 1.00 

4^* See pages 14 and 15 for list of ? Quiz-Compends t 



?QUIZ-COMPENDS? 

The Best Compends for Students' Use 
in the Quiz Class, and when Pre- 
paring for Examinations. 

Compiled in accordance with the latest teachings of promi- 
nent Lecturers and the most popular Text-books. 

They form a most complete, practical, and exhaustive 
set of manuals, containing information nowhere else col- 
lected in such a condensed, practical shape. Thoroughly 
up to the times in every respect, containing many new 
prescriptions and formulae, and over two hundred and 
fifty illustrations, many of which have been drawn and 
engraved specially for this series. The authors have had 
large experience as quiz-masters and attaches of colleges, 
with exceptional opportunities for noting the most recent 
advances and methods. 

Cloth, each $1.00. Interleaved for Notes, $1.25. 
No. 1. HUMAN ANATOMY, " Based upon Gray." Fifth 
Enlarged Edition, including Visceral Anatomy, formerly 
published separately. 16 Lithograph Plates, New 
Tables, and 117 other Illustrations. By Samuel O. L. 
Potter, m.a., m.d., m.r.c.p. (Lond.), late A. A. Surgeon U. S. 
Army, Professor of Practice, Cooper Medical College, San Fran- 
cisco. 
Nos. 2 and 3. PRACTICE OF MEDICINE. Fourth Edi- 
tion. By Daniel E. Hughes, m.d., Demonstrator of Clinical 
Medicine in Jefferson Medical College, Philadelphia. In two parts. 
Part I. — Continued, Eruptive, and Periodical Fevers, Diseases 
of the Stomach, Intestines, Peritoneum, Biliary Passages, Liver, 
Kidneys, etc. (including Tests for Urine), General Diseases, etc. 

Part II. — Diseases of the Respiratory System (including Phy- 
sical Diagnosis), Circulatory System, and Nervous System; Dis- 
eases of the Blood, etc. 

*#* These little books can be regarded as a full set of notes upon 
the Practice of Medicine, containing the Synonyms, Definitions, 
Causes, Symptoms, Prognosis, Diagnosis, Treatment, etc., of each 
disease, and including a number of prescriptions hitherto unpub- 
lished. 

No. 4. PHYSIOLOGY, including Embryology. Sixth 
Edition. By Albert P. Brubaker, m.d., Prof, of Physiology, 
Penn'a College of Dental Surgery; Demonstrator of Physiology 
in Jefferson Medical College, Philadelphia. Revised, Enlarged, 
with new Illustrations. 
No. 5. OBSTETRICS. Illustrated. Fourth Edition. By 
Henry G. Landis, m.d.. Prof, of Obstetrics and Diseases of 
Women in Starling Medical College, Columbus, O. Revised 
Edition. New Illustrations. 



BLAKISTON'S ? QUIZ-COMPENDS ?. 

No. 6. MATERIA MEDICA, THERAPEUTICS, AND 
PRESCRIPTION WRITING. Fifth Revised Edition. 

With especial Reference to the Physiological Action of Drugs, 
and a complete article on Prescription Writing. Based on the 
Last Revision of the U. S. Pharmacopoeia, and including many 
unofficinal remedies. By Samuel O. L. Potter, m.a., m.d., 
m.r.c.p. (Lond.), late A. A. Surg. U. S. Army ; Prof, of Practice, 
Cooper Medical College, San Francisco. Improved and Enlarged, 
with Index. 
No. 7. GYNECOLOGY. A Compend of Diseases of Women. 
By Henry Morris, m.d., Demonstrator of Obstetrics, Jefferson 
Medical College, Philadelphia. 45 Illustrations. 

No. 8. DISEASES OF THE EYE AND REFRACTION, 

including Treatment and Surgery. By L. Webster Fox, m.d., 
Chief Clinical Assistant Ophthalmological Dept., Jefferson Med- 
ical College, etc., and Geo. M. Gould, m.d. 71 Illustrations, 39 
Formulae. Second Enlarged and improved Edition. Index. 

No. 9. SURGERY, Minor Surgery and Bandaging. Illus- 
trated. Fourth Edition. Including Fractures, Wounds, 
Dislocations, Sprains, Amputations, and other operations; Inflam- 
mation, Suppuration, Ulcers, Syphilis, Tumors, Shock, etc. 
Diseases of the Spine, Ear, Bladder, Testicles, Anus, and 
other Surgical Diseases. By Orville Horwitz, a.m., m.d., 
Demonstrator of Surgery, Jefferson Medical College. Revised 
and Enlarged. 84 Formulae and 136 Illustrations. 

No. 10. CHEMISTRY. Inorganic and Organic. For Medical 
and Dental Students. Including Urinary Analysis and Medical 
Chemistry. By Henry Leffmann, m.d., Prof, of Chemistry in 
Penn'a College of Dental Surgery, Phila. Third Edition, Revised 
and Rewritten, with Index. 

No. 11. PHARMACY. Based upon " Remington's Text-book 
of Pharmacy." By F. E. Stewart, m.d., ph.g., Quiz-Master 
at Philadelphia College of Pharmacy. Third Edition, Revised. 

No. 12. VETERINARY ANATOMY AND PHYSIOL- 
OGY. 29 Illustrations. By Wm. R. Ballou, m.d., Prof, of 
Equine Anatomy at N. Y. College of Veterinary Surgeons. 

No. 13. DENTAL PATHOLOGY AND DENTAL MEDI- 
CINE. Containing all the most noteworthy points of interest 
to the Dental student. By Geo. W. Warren, d.d.s., Clinical 
Chief, Penn'a College of Dental Surgery, Philadelphia. Illus. 

No. 14. DISEASES OF CHILDREN. By Dr. Marcus P. 
Hatfield, Prof, of Diseases of Children, Chicago Medical 
College. Colored Plate. 

Bound in Cloth, $1. Interleaved, for the Addition of Notes, $1.25. 



These books are constantly revised to keep up with 
the latest teachings and discoveries, so that they contain 
all the new methods and principles. No series of books 
are so complete in detail, concise in language, or so well 
printed and bound. Each one forms a complete set of 
notes upon the subject under consideration. 

Illustrated Descriptive Circular Free. 



JUST PUBLISHED. 



GOULD'S NEW 

Medical Dictionary 




compact. 

CONCISE. 

PRACTICAL. 

AGGURATE. 

IcOiMPREHENSIVE 

UP TO DATE. 



It contains Tables of the Arteries, Bacilli, Gan- 
glia, Leucomaines, Micrococci, Muscles, 
Nerves, Plexuses, Ptomaines, etc., 
etc., that will be found of great 
use to the student. 



Small octavo, 520 pages, Half-Dark Leather, . $3.25 
With Thumb Index, Half Morocco, marbled edges, 4.25 



From J. M. DaCOSTA, M. D., Professor of Practice and 
Clinical Medicine, Jefferson Medical College, Philadelphia. 

"I find it an excellent work, doing credit to the learning and 
discrimination 0/ the author." 

*** Sample Pages free. 



